PERFORMANCE OF THE BELGIUM

HEALTH SYSTEM IN INTERNATIONAL

COMPARISON

Academic session: “Looking back with an eye on the future”13 January 2017

Mark Pearson - Deputy DirectorEmployment, Labour and Social Affairs

BELGIUM HAS A HIGH PERFORMING HEALTH

SYSTEM

2

Some indicators of health status and quality of

care are amongst the best in the OECD

Life expectancy at birth

Ischemic heart disease

mortality rates

CHD hospital admission in

adults

Belgium OCDE

81.4 year

244.4 / 100 000 hab182.7 / 100 000 hab

80.6 year

114 / 100 000 hab.78.4 / 100 000 hab.

In-hospital case-fatality

rates for stroke 7.3 / 100 admissions 8.0 /100 admissions

Health expenditure as a %

of GDP10.4 % 9.0 %

Colorectal cancer five-year

relative survival62.4 %66.9 %

Source: OECD Health Statistics 2016.3

Most patients are positive about their

experience with ambulatory care

4Source: Commonwealth Fund International Health Policy Survey 2013 and other national sources.

D

Doctor spending enough time with patient in

consultation, 2013 (or latest year)

Doctor providing easy-to-understand explanations,

2013 (or latest year)

1. National sources. 2. Data refer to patient experiences with regular

doctor.

1. National sources. 2. Data refer to patient experiences with regular

doctor.

Note: 95% confidence intervals represented by H. Note: 95% confidence intervals represented by H.

59.6

78.3

79.3

79.6

80.0

80.9

81.8

83.6

84.9

85.1

86.3

86.5

86.9

88.2

89.6

92.6

95.6

97.2

97.5

0 20 40 60 80 100

Poland 1, 2

Sweden 2

Canada 2

Norway 2

France 2

United States 2

Israel 1

Switzerland 2

OECD18

Netherlands 2

United Kingdom 2

Australia 1

Estonia 1

Germany 2

Portugal 1, 2

New Zealand 1

Luxembourg 1

Czech Republic 1

Belgium 1

A Age-standardised rates per 100 patients

69.5

81.8

81.9

83.2

83.7

84.1

85.4

85.9

86.3

86.8

87.4

87.9

89.5

90.7

90.9

96.2

96.3

96.3

97.5

97.8

0 20 40 60 80 100

Poland 1, 2

Sweden 2

Switzerland 2

Israel 1

France 2

Norway 2

Canada 2

Australia 2

United States 2

Netherlands 2

Estonia 1, 2

OECD19

United Kingdom 2

Germany 2

New Zealand 1

Czech Republic 1

Japan 1

Portugal 1, 2

Luxembourg 1

Belgium 1

Age-standardised rates per 100 patients

But 3 important challenges do lie ahead for

Belgium

Inequalities in health and

access to care

Low spending on pre-

vention and rising risk

factors

Waste in clinical care

Direct impact on

population health

Direct or indirect

impact on health

care costs

Social and economic

consequences

1

2

3

5

REDUCING INEQUALITIES IN HEALTH AND ACCESS

TO CARE

6

Inequality in longevity by education groups is

among the highest in Belgium

B. 65 year-olds

35

40

45

50

55

60

65

ES

T²H

UN

LVA

CZ

EP

OL

SV

K²

CH

LO

EC

D³

SV

NB

EL

FIN

ME

XU

SA

DN

KTU

RN

OR

AU

TFR

AN

ZL

PR

T²A

US

SW

EIS

RIT

A²

GB

R

Low education High education

Men

35

40

45

50

55

60

65

LVA

ES

T²H

UN

PO

LC

HL

BE

LS

VK

²M

EX

CZ

ED

NK

US

AO

EC

D³

FIN

TUR

NO

RS

WE

NZ

LG

BR

SV

NIS

RA

UT

AU

SP

RT²

ITA

²FR

A

Women

Life expectancy by gender and educational attainment at age

25 (2012 or closest year)

Source: Fabrice Murtin (2016), "Annex: Inequalities in Longevity by Education in OECD countries:

Insights from New OECD Estimates

7

The burden of unmet needs for medical

examination fell heaviest on low income groups

Percentage of people with unmet needs

for medical examination, 2014

Source: Eurostat Database, based on EU-SILC. 8

Belgium EU

STRENGTHENING PREVENTION AND

PRIMARY CARE

9

Spending on prevention represents only

2.1% of current health spending

Source: OECD Health Statistics 2016.10

Risk factors are worsening, having social

and economic consequences

2nd highest rate

across the EU

(increased by 16%

from 2000 to 2014)

Less than 1 adult

in 5 is obese, but

on the rise in

recent years

At age 15, less

than 1 in 10 girls

report daily

physical activity

Risk factors are associated with numerous chronic diseases,

having large employment and productivity impacts

Alcohol

consumptionObesity rates Physical activity

High social disparities in risk factors

(eg. smoking prevalence is twice among low education groups)

Source: OECD Health Statistics 2016. 11

The total cost of mental health amounts

to 3.4% of GDP in Belgium

• Suicide mortality rates are 1.5 times

higher the EU average

• The indirect costs are larger than

direct medical costs of mental ill-

health

• People with mental disorders

underperform in the labor market :

• Employment rates are 15

percentage points lower

• Unemployment rates are 10

percentage points higher

• Higher risk of living in poverty

and social marginalisation

7%

12%

17%

36%

UnitedKingdom

EU 28 Belgium Lithuania

Suicide mortality rates, 2013Age-standardised rates of suicides, per 100 000

population

Source: Eurostat Database.12

REDUCING WASTE IN CLINICAL CARE

13

Prescribing patterns in primary care raise

concerns about appropriateness of care

Overall volume of antibiotics prescribed, 2014 (or nearest year)

Source: European Centre for Disease Prevention and Control 2016; OECD Health Statistics 2016.14

Adverse events are often preventable, while

devastating for patients

Percentage of hospitalised patients with at least one healthcare-

associated infection, 2011-12

Source: ECDC 2013 Point prevalence survey.

15

Collecting more patient-reported measures will

improve both health system policy and practice

Outcome of treatments

that people care about

People's experience of

care

• levels of pain;

• Ability to live

independently,

• quality of life, …

• Good communication;

• Being involved in

decisions about care,

• Convenience, …

In Sweden, patient-reported

outcomes were used to identify

brands of hip prosthesis that did

little to improve mobility and pain

Source: OECD (2013), OECD Reviews of Health Care Quality: Sweden 2013

It has improved patient outcomes,

and saved the Swedish health care

system an estimated SEK 1 billion

(EUR 100 million) over seven years.

16

Key policy challenges

17

More prevention and

strengthen primary

care

Tackle waste

2

3

• Reduce risk factors and postpone chronic

diseases

• Better manage chronic diseases

• Reduce the detrimental labour market

impacts of ill-health

• Ensure patients get care that is aligned

with the outcomes that matter to them

• PaRIS will standardise international

benchmarcking and develop new patient

reported indicators

Reduce inequalities1• Tackle financial and non-financial barriers

to improve access to care for

socioeconomically disadvantaged

Read more about OECD work Follow us on Twitter: @OECD_Social

Website: www.oecd.org/health

Newsletter: http://www.oecd.org/health/update

Thank you

OECD Health Ministerial

and

Policy Forum on the

Future of Health

Paris, 16-17 January 2017

18