Background and method
The report "Health at a Glance 2009: OECD Indicators" is recently published by the OECD (www.oecd.org/health/healthataglance ). It shows the comparisons of health care systems, and their results at a number of dimensions. The OECD report has used different indicators of health and health care in OECD countries and selected data based on their relevance for policy and whether they are available and comparable.
The Norwegian Knowledge Centre for Health Services would like to comment some selected topics on important aspects of the Norwegian health services in relation to the OECD. We would thereby contribute to the ongoing debate about the organization and prioritization in the Norwegian health system. Emphasis is placed on the specific circumstances that made Norway clearly stood out from other OECD countries. We also discuss data quality and comparability, since countries differ in population composition, financing and organizing of health services, as well as different ways to record and report data.
Results and discussion
Health status and non-medical determinants of health
Health status in Norway is generally good, with higher life expectancy and lower morbidity and mortality than the OECD average. Increasing prevalence of overweight, obesity and diabetes is a negative trend in the OECD, which also applies to Norway, although the Norwegian prevalence is below the OECD average.
Our non-medical determinants of health are also favourable compared to the OECD, with lower consumption of tobacco and alcohol, and higher consumption of fruit. One particularly positive finding is that the proportion of adolescents who smoke is among the lowest in the OECD. However, Norwegian youths score among the lowest regarding physical activity.
Health system expenditures and results
Norway has the second highest health expenditure per capita after the United States. If health spending is calculated as a percentage of the gross domestic products (GDP), Norway is in the OECD average, ie 8.9% of GDP. Norway stands out with the highest resources spent on long-term care and the highest number of nurses per capita in the OECD.
With the much higher expenditure on health care than most other countries, it is imperative to ask whether we have proportionately more health care results. While Norway has shown the greatest reduction in hospital mortality due to stroke, the 5-year survival rate of breast, cervix and colorectal cancer in Norway is at about the OECD average. There are still many areas in the Norwegian health service where we do not have reliable performance indicators.
The residents of Norway have good health status and health habits. While the Norwegian health expenditure is among the highest in the OECD, the Norwegian health system delivers results at the OECD average in areas where we have reliable data. At the same time we lack comparable data on performance for large parts of the health service. We therefore think it is necessary to strengthen the work on the development of a national quality indicator system.