Reports

Lithuania is one of the fastest-ageing countries in Europe. Its working-age population is not only ageing, but also expected to decline significantly, giving rise to considerable economic, labour market, social and public governance challenges. The inclusion of older persons has improved in many areas in the past two decades. Yet, many Lithuanians aged 55 and over continue to lag in fully engaging in society relative to younger people and their peers in neighbouring countries. This report takes a holistic approach to analyse Active Ageing policies in Lithuania in three dimensions: labour market inclusion, social policies, and participation in public and political life. It provides tailored policy recommendations to improve the well-being of older people in Lithuania in terms of better employment and lifelong learning outcomes, stronger integration in society, and participation in democratic institutions and processes.

Ce rapport présente une analyse internationale approfondie de la situation des travailleurs du secteur des soins de longue durée au regard des différentes dimensions de la qualité des emplois. Dans les premières phases de la pandémie de COVID-19, les applaudissements adressés aux soignants ont été l’expression manifeste de la reconnaissance de leur travail acharné et des risques auxquels leurs fonctions les exposaient. Cependant, alors que les applaudissements se faisaient plus rares après le pic de la crise, la question de l’amélioration durable des conditions de travail des personnels du secteur des soins de longue durée est revenue sur le devant de la scène. Au cours des prochaines décennies, la demande de travail en provenance des entreprises de ce secteur va augmenter sensiblement. Plusieurs pays sont déjà confrontés à des pénuries à mesure que la génération du baby-boom entre dans le troisième âge. Pour aller Au-delà des applaudissements, il est nécessaire d’adopter une stratégie d’action globale pour remédier aux conditions de travail médiocres et à la reconnaissance sociale insuffisante des personnels du secteur des soins de longue durée, attirer des travailleurs et éviter que les pénuries de main-d’œuvre n’atteignent des niveaux inacceptables. Une stratégie de ce type doit prendre en compte plusieurs dimensions et s’adapter aux priorités de chaque pays, par exemple mettre en place des interventions directes visant à augmenter les salaires et à relever les qualifications requises ; augmenter les financements publics et développer le rôle moteur des pouvoirs publics ; soutenir la négociation collective et le dialogue social ; renforcer la formation ; développer le recours aux nouvelles technologies ; et consolider les politiques de prévention dans le domaine de la santé. Il s’agit d’une version abrégée de la publication d’origine, composée du résumé et du chapitre 1, qui est le chapitre de présentation générale.

The Menzis Shared Savings Program was initiated in 2014 by the Dutch insurer Menzis and the national primary care organisation Arts en Zorg, and is among the first value-based payment models for primary care in Europe. It runs as a complement to the current – volume-driven – primary care payment system. This paper reviews the evidence of the impact of this programme against its stated objectives. The Menzis Shared Savings Program led to a lower volume of care, particularly in terms of referrals to specialist care, laboratory care and general practitioners care. Main facilitating factors were the advanced data infrastructure in place, communication and transparency about the programme’s parameters, and the programme’s focus on mitigating financial risk and uncertainty for providers. Shared savings models – even when added as a mere complement to existing volume-driven payment methods – could enhance value in health systems.

The Health System Performance Assessment (HSPA) framework for Estonia acts as a tool for stakeholders and policy makers to guide health reforms in an evidence-based and targeted manner. This report outlines the Estonian HSPA framework and documents its development through a highly inclusive and consultative process. It also reports on indicators that were selected to populate the first Estonian HSPA report, their selection criteria and core methodologies, and describes the HSPA governance structure, implementation plan, and HSPA capacity building. The report provides a guideline to embed the HSPA in Estonian governance processes in a sustainable manner. Implementing the HSPA will improve systematised public reporting on the health system performance in Estonia, thus increasing transparency and accountability of stakeholders and public awareness and involvement in the health system policy making.

The 2018 OECD report Pharmaceutical Innovation and Access to Medicines noted that fostering competition in both on- and off-patent markets can improve the efficiency of pharmaceutical spending. Various policies are used to promote competition among off-patent medicines, but generally do not induce competition in on-patent markets. While tendering is widely used for hospital and other institutional purchasing, it is less common for ambulatory care medicines, or where medicines are reimbursed rather than supplied directly. As part of its broader work agenda on 'Increasing the transparency of pharmaceutical markets to inform policies', this paper explores how payers could harness competition to improve the efficiency of spending on medicines still subject to patent protection or regulatory exclusivity. The OECD undertook an extensive analysis consisting of two parts: 1) a quantitative analysis using product-level time series sales data to explore whether therapeutic competition occurs, and, if so, how it has affected prices and volumes over time, based on a sample of countries and therapeutic classes and 2) a review of current practices and policies on pricing, coverage and procurement of on-patent medicines to identify whether these have been influencing competition between alternative therapeutic products. This report presents the key findings from this analytical work.

The health system performance assessment (HSPA) framework for the Czech Republic is an initiative designed to help the Czech health system improve policy planning, monitoring, and decision taking. This report describes the HSPA framework for the Czech Republic, its development process, governance structure and implementation roadmap. It also details the Czech HSPA framework domains, populated by indicators selected through a comprehensive review process. As such, the framework enables the assessment of strengths and weaknesses of the Czech health system. Its implementation will increase the accountability of national authorities and principal healthcare stakeholders, improve public involvement, smooth flow of information across the health sector, and allow reform planning and monitoring.

People today are living longer with complex health needs but often receive fragmented care. This has prompted countries to support patient-centred, integrated care models. As part of OECD’s work on best practices in public health, this report outlines policy recommendations to prevent and manage chronic diseases by integrating care. Policy recommendations were drawn from a review of key integrated care models implemented in OECD and EU27 countries.

The rapid pace of technological change, coupled with a pressing need for solutions to address grand societal challenges and global crises, heightens the challenge for policy makers to develop science, technology and innovation policies at speed, in situations of high uncertainty and, in some cases, around potentially controversial technology fields. Technology assessment (TA) has a long history of providing decision-makers with timely strategic intelligence on emerging technologies. Current demands are pushing TA to evolve in order to fulfil diverse functions: to illuminate the societal, economic, environmental and other consequences of new technologies; to inform public opinion; and to guide research and development. Drawing on nine case studies, this report analyses the response of TA practices to these changing drivers and demands to support policies for new and emerging technologies. It also identifies a set of principles to guide good contemporary TA practice.