Health for the People, by the People

Building People-centred Health Systems

Health systems have to meet the changing needs of an increasingly assertive population and an ever more complex health policy context. Digitalisation, population ageing, chronic diseases, new pandemic threats, and evolving expectations of what health services should deliver – and how – have raised questions of whether health systems meet the needs and facilitate engagement of the people. Agreement is widespread that a shift towards more people-centred health systems is needed. But how this is done, and what a more people-centred health system looks like, is far less settled. The OECD Framework and Scorecard for People-Centred Health Systems identifies critical dimensions of people-centredness for health systems and benchmarks the progress countries have made towards a more people-centred approach to health. It considers the implications of the COVID-19 pandemic on people-centredness, and identifies key policies – and policy challenges – to assist the development of more people-centred health systems across OECD countries.

Published on December 16, 2021

In series:OECD Health Policy Studiesview more titles

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Foreword	Read PDF
Executive summary	Read PDF
An analytical framework and scorecard for people‑centred health systems	Read PDF
Designing policies to deliver people‑centred health	Read PDF
The COVID‑19 pandemic has made people‑centredness even more urgent	Read PDF

HIGHLIGHTS

With few exceptions, patient voice remains weakly embedded in decision-making processes. Just 11% (3/27) of countries reported that patients had a formal role in at least four of five key decision-making areas of health policy.
Countries have improved patients choice across many health services, but access and affordability continue to act as barriers for many people. While provider choice is widespread, access and affordability constraints affect free choice.
Patients are increasingly seeking control over their health information, to better influence their own health and the healthcare they receive. Yet while the majority of OECD countries (70%) say they are implementing ways for people to access their heath data electronically, in 2020 just two-fifths (43%) allowed patients to interact with their personal health information.
Countries have leveraged digital tools to improve integration. Despite progress in the uptake of electronic health records, establishing linkages and integration between electronic records has been slow, with primary care often excluded from close electronic integration with other parts of the health system.
Policies to address COVID-19 paid little attention to the needs of people-centred health services, especially in the early phases of the pandemic. But people’s preferences have also evolved over the pandemic and digital tools have helped communication and the roll-out of policies to incentivise vaccination rates. Since the start of the pandemic, 34 of 38 OECD countries or subnational regions have adopted forms of COVID passes.

Attitudes on a COVID-19 vaccine in 11 OECD countries, Aug 2020-April 2021
"If a vaccine for COVID-19 were available to me, I would get it"

Attitudes on a COVID-19 vaccine in 11 OECD countries

Note: April 2021 only among those reporting they had not received the vaccine.
Source: Ipsos (2021), Covid-19 Vaccination Intent. Ipsos survey for The World Economic Forum.

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Health for the People, by the People

Building People-centred Health Systems

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