Primary health care in Brazil is well-organised, the result of sustained commitment to providing high quality primary health care for the whole population. Brazil has implemented a set of reforms over the past decades to improve the distribution of doctors, develop new forms of service organisation, introduce new financing models, and implement a range of quality improvement initiatives.
In the 30 years since the inception of the Unified Health System (Sistema Único de Saúde, or SUS), Brazil has reduced health inequalities, and improved coverage and access to health care. However, mobilising sufficient financing for the universal health coverage mandate of SUS has been a constant challenge, not helped by persistent inefficiencies in the use of resources in the Brazilian health system.
Latin American countries were hard hit by COVID-19 with rates of excess mortality above the OECD average. The pandemic brought additional stress to health systems already overstretched by a growing burden of chronic diseases, unequal access to health care services, overall under-investment in health and strong budgetary restrictions, and systemic inefficiencies.
Health at a Glance provides a comprehensive set of indicators on population health and health system performance across OECD members and key emerging economies. This edition has a special focus on the health impact of COVID-19 in OECD countries, including deaths and illness caused by the virus, adverse effects on access and quality of care, and the growing burden of mental ill-health.
The report reviews a range of policies that countries have used to tackle waiting times for different services, including elective surgery and primary care consultations, but also cancer care and mental health services, with a focus on identifying the most successful ones.
Health at a Glance compares key indicators for population health and health system performance across OECD members, candidate and partner countries. It highlights how countries differ in terms of the health status and health-seeking behaviour of their citizens; access to and quality of health care; and the resources available for health. Analysis is based on the latest comparable data across 80 indicators, with data coming from official national statistics, unless otherwise stated.
Health spending continues to grow faster than the economy in most OECD countries. In 2010, the OECD published a study of strategies to increase value for money in health care, in which pay for performance (P4P) was identified as an innovative tool to improve health system efficiency in several OECD countries. However, evidence that P4P increases value for money, boosts quality of processes in health care, or improves health outcomes is limited.This book explores the many questions surrounding P4P such as whether the potential power of P4P has been over-sold, or whether the disappointing results to date are more likely rooted in problems of design and implementation or inadequate monitoring and evaluation. The book also examines the supporting systems and process, in addition to incentives, that are necessary for P4P to improve provider performance and to drive and sustain improvement. The book utilises a substantial set of case studies from 12 OECD countries to shed light on P4P programs in practice.Featuring both high and middle income countries, cases from primary and acute care settings, and a range of both national and pilot programmes, each case study features: Analysis of the design and implementationdecisions, including the role of stakeholders Critical assessment of objectives versus results Examination of the of 'net' impacts, includingpositive spillover effects and unintended consequences The detailed analysis of these 12 case studies together with the rest of this critical text highlight the realities of P4P programs and their potential impact on the performance of health systems in a diversity of settings. As a result, this book provides critical insights into the experience to date with P4P and how this tool may be better leveraged to improve health system performance and accountability. This title is in the European Observatory on Health Systems and Policies Series.
