As people get older, it becomes more likely that they will need help with day-to-day activities like cooking, cleaning, getting dressed and self-care. This type of support is known as long-term care (LTC). With rapid population ageing, countries need to rethink how systems can promote healthier ageing, improve the quality of care and find new ways to care for people at the end of their lives, while balancing the social adequacy of systems with financial sustainability.
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Rapid population ageing, tight healthcare budgets, a shortage of health workers and the recovery from the COVID-19 pandemic are all putting increased pressure on healthcare systems. As OECD countries look to prepare for the future, radical policy change is needed to ensure high-quality care is available to all while keeping spending levels sustainable.?
Key messages
Assessing health system performance is crucial to ensure that health systems meet people’s health needs and preferences and provide high-quality accessible healthcare for all. It helps policy makers to identify areas that require improvement, effectively allocate resources, and measure the progress of key policy objectives.
Health system resilience is the capacity of health systems to proactively foresee, absorb, recover from, and adapt to shocks such as pandemics, climate change, geopolitical conflicts, and cyberthreats. As countries recover from COVID-19, bolstering the overall capacity of health systems is more critical than ever. Health system resilience must be prioritised as one of the key objectives for high-performing health systems.??
While the supply of health workers has increased over the past few decades in OECD countries, the demand for healthcare has also increased due to population ageing. In order to address health workforce shortages, countries should increase the training of new health professionals, increase staff retention by improving working conditions, and encourage innovation related to work organisation and the use of new technologies to respond efficiently to the growing demand for care.
Context
Population ageing
The rapid population ageing seen across OECD countries will lead to increasing demands on health systems, and a decreasing working-age population to support them. In this context, promoting high quality of care while maintaining sustainable spending levels will present a significant challenge to health systems.
In recent decades, the share of the population aged 65 and over has doubled on average across OECD countries, increasing from less than 9% in 1960 to 18% in 2021. This varies significantly between member countries, with highs of 28.9% in Japan and 23.6% in Italy, compared to just 7.9% in Mexico and 8.8% in Colombia. This trend is expected to continue, with the proportion of the population aged 65 and over set to increase significantly.
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Health systems are under financial pressure
The growing pressure on health system budgets reflects a challenging economic climate, with competing priorities squeezing the public funds available for health. This has been exacerbated by high levels of inflation and the increasing demands of an ageing population.
In 2019, prior to the pandemic, OECD countries spent on average 8.8% of GDP on healthcare, a figure relatively unchanged since 2013. By 2021, this proportion had jumped to 9.7%. However, 2022 estimates point to a significant fall to 9.2%, reflecting a reduced need for spending to tackle the pandemic but also the impact of inflation. This increasing pressure on health systems will require major policy change to address in the coming years.
