The health system is responsible for preventing health problems (i.e. prevention) and addressing acute or chronic health problems when they arise (i.e. treatment). Quality of care refers to achieving desirable health outcomes (e.g. longer and healthier lives), and avoiding any adverse effects that result from the health care processes themselves (Kelley and Hurst, 2006).
Mortality within 30 days after hospital admission for acute myocardial infarction (AMI or heart attack), is a well-recognised hospital care outcome indicator. Across OECD countries there has been a reduction of 2.6 deaths per 100 admissions of adults aged 45 and above between 2007 and 2017, with most countries showings improvement, notably Chile and the Slovak Republic (reduction of 5.7 deaths), and the Netherlands (5.4). Only Mexico reports a marginal increase in deaths. Iceland, Denmark, Norway, the Netherlands, Australia and Sweden have the lowest rates (all below 4%).
Primary care is usually the initial point of contact between patients and the health care system, which is responsible for the prevention, early diagnosis and managing of common health conditions. Asthma, chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) are prevalent long-term conditions across OECD countries. These three conditions have well established treatments that can, for the most part, be delivered at the primary care level. A primary care system where accessible and high-quality services are provided can reduce acute deterioration in people living with asthma, COPD or CHF and reduce unnecessary admissions to a hospital (OECD, 2019).
The hospital admission rate for asthma and COPD was 183 per 100 000 population across OECD countries in 2017. Chile, Italy, Japan, Mexico and Portugal have admission rates less than one-half the OECD average. Hungary and Turkey, on the contrary, have close to twofold the rate of hospitalisations for these conditions. Latvia has the highest rate for asthma, with 93 admissions per 100 000 population, whereas Hungary has the highest rate for COPD (354 per 100 000).
On average, the rate of admissions for CHF was of 233 per 100 000 population in 2017 across OECD countries. Mexico has the lowest rate with 57, followed by Korea (88) and Chile (96). Poland has the highest rate of avoidable admissions related to this condition, 510 per 100 000, followed by Lithuania (502) and the Slovak Republic (479).
