OECD has published "Health at a Glance 2007, OECD Indicators". The publication is based on OECD Health Data 2007, a database on health and health care systems in OECD countries. It comprises six chapters discussed below. The publication includes a number of diagrams and tables as well as explanatory texts. The OECD News release in relation to "Health at a Glance 2007" can be found on the OECD website: http://www.oecd.org/health/healthataglance
Iceland compared with other OECD counries
Quality of care
For the first time, a chapter on the quality of medical care is included in Health at a Glance. An expert group with representatives from the OECD countries has, as a part of the Health Care Quality Indicators (HCQI) project, developed a set of quality indicators that indicate the quality of care in certain areas of health care. The availability of quality indicators for cross – national comparisons is limited and the indicators have to be used in the light of comparability limitations. The indicators cover a spectrum of services; the quality of care for certain acute conditions, the quality of cancer care, the quality of care related to chronic conditions and prevention of communicable diseases.
Iceland has the highest five-year relative survival rates for breast cancer, 89.4% lived for five years or more after they were diagnosed (1996 - 2000). The OECD average was 83.6%. In-hospital case-fatality rates within 30 days after admission for acute myocardial infarction was 6.4% in Iceland in 2005 as well as in both Australia and Denmark, while New Zealand sat in the first place, 5.4%. The OECD average was 10.2%. The same year the in-hospital case-fatality rates within 30 days after admission for ischemic stroke was the third lowest in Iceland or 5.8% following United Kingdom and Japan. The OECD average was 10.1%.
Health expenditure
In 2005, the average share of GDP that OECD countries devoted to health spending reached 9%. However, this share varied considerably across the OECD countries, ranging from around 6% in South Korea, Poland and Mexico to 15.3% of GDP in the United States. In Iceland, the total expenditure on health reached 9.5% of GDP in 2005 compared with 10% in 2004. The Norwegians, Swedish and Danish spent 9.1% of GDP on health in 2005, Frenchmen 11.1% and the German 10.7%. Measured in this way, Iceland is rated in the tenth place of the OECD countries.
Around 83% of the total health expenditure in Iceland was financed by the public sector in 2005 or 7.9% of GDP. In other Nordic countries, this percentage was a little higher or 84-85% with the exception of Finland where it was 78% in that year. In this regard, Luxembourg ranks highest with 91% financed by the public sector and the United States lowest with 45%.
In 2005, the average spending on health per capita in the OECD countries was 2,759 USD PPP. The highest spending country was the United States, devoting 6,401 USD per capita to health in 2005, and Turkey was the lowest, devoting 586 USD per capita. In Iceland, the expenditure per capita was 3,443 USD in 2005, in Norway 4,364 USD, in Denmark 3,108 USD and in Sweden 2,918 USD. On this scale, Iceland was in the sixth place behind the United States, Luxembourg, Norway, Switzerland and Austria.
Public health expenditure per capita in Iceland was 2,842 USD PPP in 2005, which means that Iceland was in the fourth place of the OCED countries. Above Iceland was Luxembourg with 4,851 USD in public spending per capita, Norway with 3,647 USD and United States with 2,884 USD per capita. Mexico was lowest, with 307 USD PPP per capita on public health expenditure.
Demographic context
The growth and composition of a country’s population has effect both on the demand of health care and its expenditure. Natural increase in population has slowed down in many OECD countries in recent years leading to a rise in the average age of the population. In the years 1990-2005 the annual population growth rate for OECD countries was 0.6% on average but 1% in Iceland. In 2005 the fertility rate was 1.6 children per woman of childbearing age for OECD countries on average, highest or 2.2 in Mexico and Turkey followed by Iceland and United States with 2.1.
In 2005 the share of the population aged 65 and over was 11.7% in Iceland. Only five OECD countries had a lower percentage of this age group, but the average for the OECD countries was close to 15%. The highest percentage was in Japan, 20% and Italy and Germany had 19%.
Health status
In most OECD countries life expectancy at birth has increased markedly in recent decades. In 2005 life expectancy at birth for the total population was 81.2 years in Iceland and only higher in Japan (82.1) and Swiss (81.3). Life expectancy was 78.6 years for the OECD countries on average. Life expectancy of men was highest in Iceland 79.2 years but life expectancy of Icelandic women was in 7th place, or 83.1 years. Gender gap in life expectancy at birth was 5.7 years on average for OECD countries, narrowest in Iceland or 3.9 years.
The mortality rates for lung cancer were similar for men and women in Iceland in 2004 38 per 100.000 population (age standardised) which is unusual compared with other OECD countries where the gender gap is generally wide. The mortality rate for lung cancer for men was lowest in Sweden followed by Iceland but for women it was highest in Denmark followed by Iceland. For OCED countries on average the mortality rate for lung cancer per 100,000 population was 58 for men and 20 for women.
In the year 2005 the rate of infant mortality was lowest in Iceland or 2.3 deaths of infants per 1000 life births. At the same time the average for OECD countries was 5.4. The percentage of low birth weight infants (below 2500 grams) was also lowest in Iceland or 3.9% of live births with OECD average at 6.6%.
The average number of decayed, missing or filled teeth of 12 years old children (DMFT) was 2.1 in Iceland in 2005 but 1.6 on average for the OECD countries. DMFT was lowest in Germany 0.7, 0.9 in Denmark and 3.8 in Poland where it was highest.
Non-medical determinants of health
In Iceland 19.5% of men and women smoked daily in 2005. The average for OECD was similar to the Icelandic average for women but higher for men or close to 30%.
Alcohol consumption was 7.1 litres alcohol per capita 15 years and over in Iceland in 2005, a little more than in Norway and Sweden. The average for OECD countries was 9.5 litres. In two thirds of OECD countries, the average alcohol consumption has fallen to some extent since 1980. However, alcohol consumption has increased by 65% in Iceland since 1980.
In 2005 (or the closest year available) the obese rate was lowest in Japan 3% but highest in United States 32%. In Iceland the obesity rate was 12% in 2002 compared with 8% in 1990.
Health care resources and utilisation
The number of practicing physicians per 1000 population was 3.7 in Iceland as well as in Norway and Netherlands in 2005 while the average for OECD countries was 3.0. The sum of practicing nurses and practical nurses per 1000 population was 14.0 in Iceland but the average for OECD was around 9.0.
In 2005 the number of nursing beds in hospitals and nursing homes per 1000 population 65 years and over was 69 in Iceland but the average for OCED countries was 41. This rate varies greatly by country partly due to different organisation of long-term care and how well the data complies with the OECD definition.
Average length of hospital stay had decreased from 7.0 days in 1990 to 5.4 days in 2005 in Iceland. At the same time the average for OECD decreased from 8.7 to 6.3 per 1000 population. The average length of stay for normal delivery in Iceland was 2.1 days which is less than in other Nordic countries and less than the OECD average of 3.3 days. In Iceland the number of caesarean sections per 100 live births was 16 in 2005 but 24 on average in OECD countries.