Health Status Determinants

Abstract

This paper aims to shed light on the contribution of health care and other determinants to the health status of the population and to provide evidence on whether or not health care resources are producing similar value for money across OECD countries. First, it discusses the pros and cons of various indicators of the health status, concluding that mortality and longevity indicators have some drawbacks but remain the best available proxies. Second, it suggests that changes in health care spending, lifestyle factors (smoking and alcohol consumption as well as diet), education, pollution and income have been important factors behind improvements in health status. Third, it derives estimates of countries' relative performance in transforming health care resources into longevity from two different methods -panel data regressions and data envelopment analysis -which give remarkably consistent results. The empirical estimates suggest that potential efficiency gains might be large enough to raise life expectancy at birth by almost three years on average for OECD countries, while a 10% increase in total health spending would increase life expectancy by three to four months.

Healthcare policy tools as determinants of health-system efficiency: evidence from the OECD

“…A potential alternative in health-system classification is the work of Joumard et al (2008Joumard et al ( , 2010 that might provide an improved set of health-system variables to use in empirical estimation. Life expectancy is a crude measure of health outcome; one might argue that the contribution of a health system to life expectancy is relatively small in comparison with other factors, such as environment and lifestyles.…”

“…The assumption of a positive relationship between health spending and health outcomes is questioned by some (Navarro, 2000;Pedersen, 2002), but is not uncommon and forms the basis for a number of key studies (Cremieux, 1999;Nixon and Ulmann, 2006;Self and Grabowski, 2003;Joumard et al, 2008Joumard et al, , 2010. The assumption of a positive relationship between health spending and health outcomes is questioned by some (Navarro, 2000;Pedersen, 2002), but is not uncommon and forms the basis for a number of key studies (Cremieux, 1999;Nixon and Ulmann, 2006;Self and Grabowski, 2003;Joumard et al, 2008Joumard et al, , 2010.…”

“…Life expectancy as the outcome of a health system is used also by Or et al (2001Or et al ( , 2005, whereas Berger and Messer (2002) use OECD mortality rates. 9 Life expectancy is preferred to disease-specific or treatment-specific measures of survival, as it better lends itself to system-level assessment (Joumard et al, 2008). Neither measure is perfect.…”

“…As these measures are highly correlated, the choice of a specific indicator should not greatly influence the conclusion (Joumard et al, 2008). The interpretation of such transformed measures would be challenging.…”

The Dutch fiscal consolidation package in a comparative perspective

“…We are not saying that focusing on operational costs is not a promising way of consolidation. Indeed, OECD studies indicate that there are large differences in ratios of outputs and outcomes to inputs among OECD countries, particularly in areas such as education and health (Joumard et al, 2008;Sutherland and Price, 2007). However, it is essential for success that measures are clearly specified.…”