Health at a Glance 2015 is the name of a 220 pages document recently published by the OECD comprising the most recent data on the performance of health systems, including a dashboard of health indicators, a special focus chapter on the pharmaceutical sector, and indicators on health workforce migration and health care quality. Comparisons across the 34 OECD countries and key partner countries such as Brazil, China, Colombia, Costa Rica, India, Indonesia, Latvia, Lithuania, the Russian Federation, and South Africa are presented. The performance of the health systems is assessed in the context of public healthcare based on a general framework, which recognizes health status of the population as the primary goal of every health system. Among the factors influencing health status are non-medical determinants such as the physical environment in which people live and individual lifestyles and behaviors; the performance of health care systems including the degree of access to care and quality of care provided; the human and financial resources available for health care activities; and the supply and demand for health care services driven by demographic, social, and economic trends.
The measures of population health status, such as life expectancy, are not only related to health spending and the performance of health systems, but actually to the non-medical determinants of health. Japan, Switzerland, Italy, and France are the countries with the highest life expectancy at birth, while Mexico, Hungary, the Slovak Republic, and Turkey have the lowest expectancy at birth and older ages. Along with Korea and Turkey, Mexico has the highest increase in life expectancy, passing from 61 years in 1970 to 74.6 years in 2013. Moreover, life expectancy for women is 77.4 years and for men is 71.7. Life expectancy in OECD countries varies not only by gender, but also by socio-economic status such as the education level. In Mexico there is a gap of 5.2 years in the expected years of life between adults with the highest level of education and the lowest level.
Cardiovascular diseases remain the main cause of mortality in most OECD countries, accounting for 32.3% of all deaths in 2013. Central and Eastern European countries report the highest ischemic heart disease mortality rates – around 300 per 100,000 thousand people. In Mexico, IHD rates are 140 per 100,000, above the OECD average of 117. Cancer is the second leading cause of mortality in OECD. In 2013, the average rate of mortality due to cancer across OECD countries was just over 200 per 100,000 people. Mexico has the lowest levels of cancer mortality among the OECD members, with rates less than 130. Contrastingly, Mexico has the highest rate of deaths due to transport accidents – five times more than in the UK and Sweden.
Obesity, a well-known risk factor for hypertension, diabetes, high cholesterol, cardiovascular diseases, and asthma, is a major public health concern given that 53.8% of the adult population in OECD countries is either overweight or obese. The US and Mexico are the countries with the highest obesity rates – 35.3% and 32.4% respectively.
This document defines healthcare coverage as the share of the population receiving a set of goods and services as well as financial security against unexpected or serious illness. Most OECD countries have achieved universal coverage – or near-universal coverage – including consultations, examinations, tests, and surgical and therapeutic procedures. In Mexico, the public healthcare system covers 91.6% of the population, and 7.3% has a private health insurance – one of the lowest among the 34 countries.
Pharmaceutical spending across OECD countries reached US$800 billion in 2013. Retail pharmaceutical spending is slowing down in most countries, while government spending is increasing. One in every five health dollars is spent on pharmaceuticals. An increasing demand for pharmaceuticals and new treatment opportunities push pharmaceutical spending up. The IMS Institute for Healthcare Informatics estimate pharmaceutical sales to be 30% higher in 2018 than in 2013. The average annual growth rate is higher than in previous years as the number of patent expiries decreases and the number of new specialty drugs keeps on growing. Emerging markets are expected to contribute significantly to this growth.
Mexico is among the countries with the lowest number of consultations with doctors – 2.8 consultations per person in 2013. Moreover, Mexico has 1.6 beds per 1000 population. This indicator provides information about the resources available for delivering services to inpatients at hospitals. Countries such as Japan and Korea have up to 11 beds per 1000 population. The number of hospital beds per capita has decreased in the past decade from 5.5 in 2000 to 4.8 in 2013, mostly due to improvements in medical technology enabling rapid discharge of patients after surgeries and reduced need for hospitalization. The number of doctors per capita varies widely across the OECD countries. Turkey, Korea, and Mexico have shown a rapid increase in the number of doctors per capita as they started with lower levels in 2000. However, Mexico still had 2.2 practicing doctors per 1000 population in 2013, which is below the OECD average of 3.3.
All of these suggests Mexico still has a lot of work to do in order to provide better health care services and improve the health status of the population. The objectives of the Sectorial Program of Health aim to accomplish this and greater collaboration among the different actors is crucial.