All Global Healthcare Report 2014

Global Healthcare Report

Global Healthcare Report

Content

04 Countries 154 Statistics 170 Hospital Hierarchy 172 Sources

Content

04 Countries 154 Statistics 170 Hospital Hierarchy 172 Sources

Welcome

All Global are international healthcare data specialists. We provide high quality healthcare research services for top global research companies and agencies across Europe, North and South America and Asia-Pacific. We target the right people using the right channels to deliver global, regional, local and niche stakeholder insights that will make a tangible difference to your business. Over time, we have established great relationships with our stakeholders – payers, key opinion leaders, healthcare professionals and patients – which translate into higher response rates and stronger, more reliable data for you.

2

Global Healthcare Report

We will partner with you to find the right combination of methodologies – qualitative and quantitative, online and traditional – to produce bold, considered, clear research that puts you and your clients ahead of the competition.

Welcome

3

Welcome

All Global are international healthcare data specialists. We provide high quality healthcare research services for top global research companies and agencies across Europe, North and South America and Asia-Pacific. We target the right people using the right channels to deliver global, regional, local and niche stakeholder insights that will make a tangible difference to your business. Over time, we have established great relationships with our stakeholders – payers, key opinion leaders, healthcare professionals and patients – which translate into higher response rates and stronger, more reliable data for you.

2

Global Healthcare Report

We will partner with you to find the right combination of methodologies – qualitative and quantitative, online and traditional – to produce bold, considered, clear research that puts you and your clients ahead of the competition.

Welcome

3

Countries

Countries

Argentina Healthcare System • The Ministry of Health is responsible for public health services, government hospitals and medical services. • There are three levels of healthcare provision: Public, Social (Obras Sociales) and Private. • Public health is financed via the national budget and managed by the national, provincial and municipal governments. It mostly covers the unemployed and low income groups but it also runs the majority of emergency care. • Social healthcare provision is funded by employers and employees who pay into a scheme organized by the trade union linked to the occupation of the beneficiary. These schemes are overseen by the National Health Insurance Administration. • The day-to-day provision of public services is done at a municipal level, leading to variation in levels of care. • The private sector accounts for 44% of total health expenditure. Reimbursement Policies • The public sector is funded by taxation and accounts for 22% of total health expenditure. 2% is raised nationally, 16% provincially and 4% municipally. • Obras Sociales account for 24% of total health expenditure. • The unions outsource the provision of healthcare services to the private sector and patients have to pay the difference between the cost of treatment and a fixed fee. • Out-of-pocket payments account for 28% of the total health expenditure.

Public versus Private Public • The national Ministry of Health administers only four hospitals. • About 1,000 public hospitals are run by the provinces, while the remainder are run by municipalities. Obras Sociales • 3% of hospital beds are in the Obras Sociales. • There are over 300 Obras Sociales schemes, the top 10% cover 75% of the group’s beneficiaries. Private • 47% of hospital beds are in the private sector. • Approximately four million individuals, 10% of the population, have private insurance. News, Developments and Notes • Language: Spanish. • Regulator: The National Administration of Drugs, Foods and Medical Technology. • Free healthcare for all is written into Argentina’s constitution.

Argentina

7

Argentina Healthcare System • The Ministry of Health is responsible for public health services, government hospitals and medical services. • There are three levels of healthcare provision: Public, Social (Obras Sociales) and Private. • Public health is financed via the national budget and managed by the national, provincial and municipal governments. It mostly covers the unemployed and low income groups but it also runs the majority of emergency care. • Social healthcare provision is funded by employers and employees who pay into a scheme organized by the trade union linked to the occupation of the beneficiary. These schemes are overseen by the National Health Insurance Administration. • The day-to-day provision of public services is done at a municipal level, leading to variation in levels of care. • The private sector accounts for 44% of total health expenditure. Reimbursement Policies • The public sector is funded by taxation and accounts for 22% of total health expenditure. 2% is raised nationally, 16% provincially and 4% municipally. • Obras Sociales account for 24% of total health expenditure. • The unions outsource the provision of healthcare services to the private sector and patients have to pay the difference between the cost of treatment and a fixed fee. • Out-of-pocket payments account for 28% of the total health expenditure.

Public versus Private Public • The national Ministry of Health administers only four hospitals. • About 1,000 public hospitals are run by the provinces, while the remainder are run by municipalities. Obras Sociales • 3% of hospital beds are in the Obras Sociales. • There are over 300 Obras Sociales schemes, the top 10% cover 75% of the group’s beneficiaries. Private • 47% of hospital beds are in the private sector. • Approximately four million individuals, 10% of the population, have private insurance. News, Developments and Notes • Language: Spanish. • Regulator: The National Administration of Drugs, Foods and Medical Technology. • Free healthcare for all is written into Argentina’s constitution.

Argentina

7

Demographics

41,660,417 km2 2,780,400 131,647 3,310 187,472 Population

Area size

Total doctors

Total hospitals

Total hospital beds

8

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Buenos Aires

7.32%

Capital Federal

City

Population

Administrative division

C贸rdoba

3.29%

C贸rdoba

City

Population

Administrative division

Rosario

2.98%

Santa Fe

City

Population

Administrative division

Mendoza

2.12%

Mendoza

City

Population

Administrative division

Tucuman

1.89%

Tucuman

Argentina

9

Demographics

41,660,417 km2 2,780,400 131,647 3,310 187,472 Population

Area size

Total doctors

Total hospitals

Total hospital beds

8

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Buenos Aires

7.32%

Capital Federal

City

Population

Administrative division

C贸rdoba

3.29%

C贸rdoba

City

Population

Administrative division

Rosario

2.98%

Santa Fe

City

Population

Administrative division

Mendoza

2.12%

Mendoza

City

Population

Administrative division

Tucuman

1.89%

Tucuman

Argentina

9

Australia Healthcare System • The government sets national health policies and subsidizes health services provided by state and territory governments and the private sector. • State and territory governments deliver health services, including most acute and psychiatric hospitals. • The public healthcare system is known as Medicare. It is funded through the Medicare Levy and taxes. • The Medicare Benefits Schedule (MBS) is the schedule of fees set by the federal government for medical services. • In 2008, public spending accounted for 69% of total health expenditure, 43% from the Australian government and 26% by state and territory governments. • Private expenditure was just over 7% of total health spending. Reimbursement Policies • Medicare rebates 100% of the full schedule fee for GP services, 85% of the non-hospital procedure fee, 75% of any inpatient fee and 85% of specialist consultations fees. • Taxpayers contribute at least 1.5% of income. • Out-of-pocket spending accounted for nearly 17% of healthcare expenditure. • Recommendations about which medications should be subsidized under the Pharmaceutical Benefits Schedule (PBS) are made by the Pharmaceutical Benefits Advisory Committee. • The PBS subsidizes a range of prescription medicines, with patients paying an additional premium on more expensive brands. • There are some 3,000 items listed on the PBS; in 2008, 334 attracted a premium.

Public versus Private Public • 10.5% of patients in public hospitals are private patients. • 752 public hospitals account for 68% of hospital beds. • 60% of patients are treated in public hospitals. • In 2012, AUD864 million in accommodation fees was paid by private health funds to public hospitals. Private • 40% of patients are treated in private hospitals. • 46.6% of residents have private insurance. • 588 private hospitals account for about 32% of beds. News, Developments and Notes • Language: English. • Regulator: Therapeutic Goods Administration. • In 2012, the government began means testing for its 30% private healthcare rebate. • Ambulance fees are not covered by Medicare. • Patients can choose their GP. • The Northern Territory only has one private hospital.

Australia

11

Australia Healthcare System • The government sets national health policies and subsidizes health services provided by state and territory governments and the private sector. • State and territory governments deliver health services, including most acute and psychiatric hospitals. • The public healthcare system is known as Medicare. It is funded through the Medicare Levy and taxes. • The Medicare Benefits Schedule (MBS) is the schedule of fees set by the federal government for medical services. • In 2008, public spending accounted for 69% of total health expenditure, 43% from the Australian government and 26% by state and territory governments. • Private expenditure was just over 7% of total health spending. Reimbursement Policies • Medicare rebates 100% of the full schedule fee for GP services, 85% of the non-hospital procedure fee, 75% of any inpatient fee and 85% of specialist consultations fees. • Taxpayers contribute at least 1.5% of income. • Out-of-pocket spending accounted for nearly 17% of healthcare expenditure. • Recommendations about which medications should be subsidized under the Pharmaceutical Benefits Schedule (PBS) are made by the Pharmaceutical Benefits Advisory Committee. • The PBS subsidizes a range of prescription medicines, with patients paying an additional premium on more expensive brands. • There are some 3,000 items listed on the PBS; in 2008, 334 attracted a premium.

Public versus Private Public • 10.5% of patients in public hospitals are private patients. • 752 public hospitals account for 68% of hospital beds. • 60% of patients are treated in public hospitals. • In 2012, AUD864 million in accommodation fees was paid by private health funds to public hospitals. Private • 40% of patients are treated in private hospitals. • 46.6% of residents have private insurance. • 588 private hospitals account for about 32% of beds. News, Developments and Notes • Language: English. • Regulator: Therapeutic Goods Administration. • In 2012, the government began means testing for its 30% private healthcare rebate. • Ambulance fees are not covered by Medicare. • Patients can choose their GP. • The Northern Territory only has one private hospital.

Australia

11

Demographics

23,345,651 km2 7,692,024 89,904 1,283 91,048 Population

Area size

Total doctors

Total hospitals

Total hospital beds

12

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Sydney

20.91%

New South Wales

City

Population

Administrative division

Melbourne

19.02%

Victoria

City

Population

Administrative division

Brisbane

9.81%

Queensland

City

Population

Administrative division

Perth

8.50%

Western Australia

City

Population

Administrative division

Adelaide

5.72%

South Australia

Australia

13

Demographics

23,345,651 km2 7,692,024 89,904 1,283 91,048 Population

Area size

Total doctors

Total hospitals

Total hospital beds

12

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Sydney

20.91%

New South Wales

City

Population

Administrative division

Melbourne

19.02%

Victoria

City

Population

Administrative division

Brisbane

9.81%

Queensland

City

Population

Administrative division

Perth

8.50%

Western Australia

City

Population

Administrative division

Adelaide

5.72%

South Australia

Australia

13

Austria Healthcare System • The federal government sets out the legislation for outpatient care and lays down the legislative framework for inpatient care. • Provincial authorities define inpatient legislation in terms of enforcement as well as ensuring its implementation. • There are 24 social insurance institutions, of which 21 are health insurance funds. Membership of a health insurance fund is mandatory and is linked to occupation. Social insurance institutions are structured either regionally or according to occupation. • 99% of inhabitants are covered by the healthcare system. • In 2007, about 76% of total health expenditure was generated from public sources. Reimbursement Policies • The federal government finances 25% of healthcare and social health insurance finances around 45% . • 21% of costs are covered by user charges and direct payments, with 15% of healthcare expenditure going on out-of-pocket levies. • Drugs placed on the positive list for outpatient care medicines, known as the Reimbursement Codex (or EKO), are generally paid for by the insurers. Of the approximately 9,800 permitted medications, around 4,200 are on the Codex.

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Global Healthcare Report

Public versus Private Public • Of the 272 hospitals, 137 are covered by public budgets. • 60% of hospitals are publicly owned. • Around 58% of beds are in public hospitals. Private • Around 30% of Austrians have additional private health insurance, mainly linked to hospital costs insurance. • 25% of beds are in private forprofit hospitals. • 16% of beds are in private not-forprofit hospitals. News, Developments and Notes • Language: German. • Regulator: Austrian Agency for Health and Food Safety. • Patients choose their GP. • Austria has one of the highest doctorto-population ratios in the EU.

Austria

15

Austria Healthcare System • The federal government sets out the legislation for outpatient care and lays down the legislative framework for inpatient care. • Provincial authorities define inpatient legislation in terms of enforcement as well as ensuring its implementation. • There are 24 social insurance institutions, of which 21 are health insurance funds. Membership of a health insurance fund is mandatory and is linked to occupation. Social insurance institutions are structured either regionally or according to occupation. • 99% of inhabitants are covered by the healthcare system. • In 2007, about 76% of total health expenditure was generated from public sources. Reimbursement Policies • The federal government finances 25% of healthcare and social health insurance finances around 45% . • 21% of costs are covered by user charges and direct payments, with 15% of healthcare expenditure going on out-of-pocket levies. • Drugs placed on the positive list for outpatient care medicines, known as the Reimbursement Codex (or EKO), are generally paid for by the insurers. Of the approximately 9,800 permitted medications, around 4,200 are on the Codex.

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Global Healthcare Report

Public versus Private Public • Of the 272 hospitals, 137 are covered by public budgets. • 60% of hospitals are publicly owned. • Around 58% of beds are in public hospitals. Private • Around 30% of Austrians have additional private health insurance, mainly linked to hospital costs insurance. • 25% of beds are in private forprofit hospitals. • 16% of beds are in private not-forprofit hospitals. News, Developments and Notes • Language: German. • Regulator: Austrian Agency for Health and Food Safety. • Patients choose their GP. • Austria has one of the highest doctorto-population ratios in the EU.

Austria

15

Demographics

8,414,638 km2 83,855 40,912 310 63,951 Population

Area size

Total doctors

Total hospitals

Total hospital beds

16

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Wien

19.78%

Wien

City

Population

Administrative division

Graz

2.94%

Steiermark

City

Population

Administrative division

Linz

2.24%

Oberรถsterreich

City

Population

Administrative division

Salzburg

1.77 %

Salzburg

City

Population

Administrative division

Innsbruck

1.40%

Tirol

Austria

17

Demographics

8,414,638 km2 83,855 40,912 310 63,951 Population

Area size

Total doctors

Total hospitals

Total hospital beds

16

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Wien

19.78%

Wien

City

Population

Administrative division

Graz

2.94%

Steiermark

City

Population

Administrative division

Linz

2.24%

Oberรถsterreich

City

Population

Administrative division

Salzburg

1.77 %

Salzburg

City

Population

Administrative division

Innsbruck

1.40%

Tirol

Austria

17

Belgium Healthcare System • Healthcare is funded through mandatory social security contributions and through health insurance schemes (mutuelle/mutualiteits) run by private or mutual insurers. • Individuals can choose an insurance scheme, although their employer usually enrolls them in one automatically, which may be linked to a union. • It is compulsory for residents to register with a social security organization to receive the Carte SIS (Social Identity Card), which is used to access care. • Belgium has one of the highest healthcare expenditures as a percentage of GDP in the EU. • 74% of total health expenditure is in the public sector and 26% in the private. Reimbursement Policies • The cost of care is partially or fully refunded, depending on criteria fixed by law. • In cases of hospitalization, patients pay supplemental charges but the main costs are paid directly to the hospital by insurers. • Out-of-pocket expenditure is around 23% of total health expenditure. • Drug reimbursements amount to, on average, 60%. The pharmacist only charges the non-insured amount. • About 2,500 pharmaceuticals are reimbursable. The amount reimbursed is determined by the pharmaceutical category. • The mutual insurers negotiate as a cartel with the drug companies on reimbursement rates under the supervision of the central government.

Public versus Private Public • 34% of beds are in public hospitals. Private • 66% of beds are in private hospitals. • 70% of all hospitals are private. • 99% of private hospitals are not-for profit hospitals. • Around 30% of the population have private health insurance. News, Developments and Notes • Language: French, Flemish, German. • Regulator: Federal Agency for Medicines and Health Products. • Patients can choose their doctor. • Belgium has one of the highest rates of GPs per capita in the EU. The number of nurses, however, is below average.

Belgium

19

Belgium Healthcare System • Healthcare is funded through mandatory social security contributions and through health insurance schemes (mutuelle/mutualiteits) run by private or mutual insurers. • Individuals can choose an insurance scheme, although their employer usually enrolls them in one automatically, which may be linked to a union. • It is compulsory for residents to register with a social security organization to receive the Carte SIS (Social Identity Card), which is used to access care. • Belgium has one of the highest healthcare expenditures as a percentage of GDP in the EU. • 74% of total health expenditure is in the public sector and 26% in the private. Reimbursement Policies • The cost of care is partially or fully refunded, depending on criteria fixed by law. • In cases of hospitalization, patients pay supplemental charges but the main costs are paid directly to the hospital by insurers. • Out-of-pocket expenditure is around 23% of total health expenditure. • Drug reimbursements amount to, on average, 60%. The pharmacist only charges the non-insured amount. • About 2,500 pharmaceuticals are reimbursable. The amount reimbursed is determined by the pharmaceutical category. • The mutual insurers negotiate as a cartel with the drug companies on reimbursement rates under the supervision of the central government.

Public versus Private Public • 34% of beds are in public hospitals. Private • 66% of beds are in private hospitals. • 70% of all hospitals are private. • 99% of private hospitals are not-for profit hospitals. • Around 30% of the population have private health insurance. News, Developments and Notes • Language: French, Flemish, German. • Regulator: Federal Agency for Medicines and Health Products. • Patients can choose their doctor. • Belgium has one of the highest rates of GPs per capita in the EU. The number of nurses, however, is below average.

Belgium

19

Demographics

11,099,554 km2 30,528 41,979 363 72,147 Population

Area size

Total doctors

Total hospitals

Total hospital beds

20

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Antwerp

4.58%

Antwerp

City

Population

Administrative division

Gent

2.24%

Oost-Vlaanderen

City

Population

Administrative division

Charleroi

1.84%

Hainaut

City

Population

Administrative division

Liège

1.77 %

Liège

City

Population

Administrative division

Brussels (city)

1.52%

Brussels

Belgium

21

Demographics

11,099,554 km2 30,528 41,979 363 72,147 Population

Area size

Total doctors

Total hospitals

Total hospital beds

20

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Antwerp

4.58%

Antwerp

City

Population

Administrative division

Gent

2.24%

Oost-Vlaanderen

City

Population

Administrative division

Charleroi

1.84%

Hainaut

City

Population

Administrative division

Liège

1.77 %

Liège

City

Population

Administrative division

Brussels (city)

1.52%

Brussels

Belgium

21

Brazil Healthcare System • Healthcare in Brazil is funded through compulsory salary-based contributions as well as federal, state and municipal taxes. • There are 26 states, one federal district and 5,564 municipalities, alongside the federal government. • The constitution guarantees unrestricted access to health services for all citizens. It is delivered via the Sistema Único de Saúde (SUS). • In 2011, 45.7% of total health expenditure was on public services. Reimbursement Policies • The public healthcare system is limited to medicines on the National List of Essential Drugs. • 75% of drugs are reimbursed by the healthcare system and the remainder are paid out of pocket by patients.

Public versus Private Public • 36.6% of hospitals are public. • 2.4% are University/Teaching hospitals. • 28.6% of the population rely on the SUS. • 40% of Brazilians do not have primary care cover and so rely on emergency hospital care. Private • 61% of all hospitals are private. • 25% of people have private medical insurance. News, Developments and Notes • Language: Portuguese. • Regulator: Health Surveillance Agency. • In São Paolo there are 2.49 doctors per 1,000 inhabitants. In wider Brazil there are 1.8. • The richest 15% of the population is responsible for over 40% of drug expenditure. • In February 2011, it was announced that medicines for hypertension and diabetes would be free. • 30% of a medicine’s price relates to fees and taxes. • Brazil is one of the leading medical tourism destinations in South America.

Brazil

23

Brazil Healthcare System • Healthcare in Brazil is funded through compulsory salary-based contributions as well as federal, state and municipal taxes. • There are 26 states, one federal district and 5,564 municipalities, alongside the federal government. • The constitution guarantees unrestricted access to health services for all citizens. It is delivered via the Sistema Único de Saúde (SUS). • In 2011, 45.7% of total health expenditure was on public services. Reimbursement Policies • The public healthcare system is limited to medicines on the National List of Essential Drugs. • 75% of drugs are reimbursed by the healthcare system and the remainder are paid out of pocket by patients.

Public versus Private Public • 36.6% of hospitals are public. • 2.4% are University/Teaching hospitals. • 28.6% of the population rely on the SUS. • 40% of Brazilians do not have primary care cover and so rely on emergency hospital care. Private • 61% of all hospitals are private. • 25% of people have private medical insurance. News, Developments and Notes • Language: Portuguese. • Regulator: Health Surveillance Agency. • In São Paolo there are 2.49 doctors per 1,000 inhabitants. In wider Brazil there are 1.8. • The richest 15% of the population is responsible for over 40% of drug expenditure. • In February 2011, it was announced that medicines for hypertension and diabetes would be free. • 30% of a medicine’s price relates to fees and taxes. • Brazil is one of the leading medical tourism destinations in South America.

Brazil

23

Demographics

201,032,714 km2 8,515,767 353,818 6,493 462,375 Population

Area size

Total doctors

Total hospitals

Total hospital beds

24

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

São Paulo

5.59%

São Paulo

City

Population

Administrative division

Rio de Janeiro

3.15 %

Rio de Janeiro

City

Population

Administrative division

Salvador

1.33%

Bahia

City

Population

Administrative division

Brasilia

1.27 %

Distrito Federal

City

Population

Administrative division

Fortaleza

1.27 %

Ceará

Brazil

25

Demographics

201,032,714 km2 8,515,767 353,818 6,493 462,375 Population

Area size

Total doctors

Total hospitals

Total hospital beds

24

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

São Paulo

5.59%

São Paulo

City

Population

Administrative division

Rio de Janeiro

3.15 %

Rio de Janeiro

City

Population

Administrative division

Salvador

1.33%

Bahia

City

Population

Administrative division

Brasilia

1.27 %

Distrito Federal

City

Population

Administrative division

Fortaleza

1.27 %

Ceará

Brazil

25

Canada Healthcare System • Canada has a national program composed of 14 interlocking provincial and territorial health insurance plans. • The system is framed by the Canada Health Act. • Roles and responsibilities are shared between the federal and provincialterritorial governments. • Federal government plans cover veterans, native Canadians, Royal Canadian Mounted Police and members of the armed forces. • Care is delivered through a mix of private and public channels. • There is no national insurance plan for outpatient prescription drugs, yet roughly 10% of the population has no insurance cover for prescription drugs. • The public sector accounts for almost 70% of total health expenditure.

Public versus Private Public • Almost all hospital care is considered a fully insured service under the Canada Health Act. Private • 66% of the population has private health insurance. • Private health insurance accounts for 12% of total healthcare expenditure. News, Developments and Notes • Language: English/French. • Regulator: Health Products and Food Branch. • Canada’s healthcare system is sometimes referred to as Medicare. • The system is closer to the European model than the US system.

Reimbursement Policies • The system is predominantly publicly financed via taxation. • All provinces have publicly-funded drug plans. • Many employers provide private group insurance coverage. • 15% of total healthcare expenditure is from out-of-pocket payments. • Each province makes its own decision about funding new drugs. • 30% of total expenditure is paid through private insurance or outof-pocket payments.

Canada

27

Canada Healthcare System • Canada has a national program composed of 14 interlocking provincial and territorial health insurance plans. • The system is framed by the Canada Health Act. • Roles and responsibilities are shared between the federal and provincialterritorial governments. • Federal government plans cover veterans, native Canadians, Royal Canadian Mounted Police and members of the armed forces. • Care is delivered through a mix of private and public channels. • There is no national insurance plan for outpatient prescription drugs, yet roughly 10% of the population has no insurance cover for prescription drugs. • The public sector accounts for almost 70% of total health expenditure.

Public versus Private Public • Almost all hospital care is considered a fully insured service under the Canada Health Act. Private • 66% of the population has private health insurance. • Private health insurance accounts for 12% of total healthcare expenditure. News, Developments and Notes • Language: English/French. • Regulator: Health Products and Food Branch. • Canada’s healthcare system is sometimes referred to as Medicare. • The system is closer to the European model than the US system.

Reimbursement Policies • The system is predominantly publicly financed via taxation. • All provinces have publicly-funded drug plans. • Many employers provide private group insurance coverage. • 15% of total healthcare expenditure is from out-of-pocket payments. • Each province makes its own decision about funding new drugs. • 30% of total expenditure is paid through private insurance or outof-pocket payments.

Canada

27

Demographics

35,158,300 km2 9,984,670 72,637 826 112,507 Population

Area size

Total doctors

Total hospitals

Total hospital beds

28

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Toronto

7.81%

Ontario

City

Population

Administrative division

MontrĂŠal

4.93%

Quebec

City

Population

Administrative division

Calgary

3.28%

Alberta

City

Population

Administrative division

Ottawa

2.64%

Ontario

City

Population

Administrative division

Edmonton

2.45%

Alberta

Canada

29

Demographics

35,158,300 km2 9,984,670 72,637 826 112,507 Population

Area size

Total doctors

Total hospitals

Total hospital beds

28

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Toronto

7.81%

Ontario

City

Population

Administrative division

MontrĂŠal

4.93%

Quebec

City

Population

Administrative division

Calgary

3.28%

Alberta

City

Population

Administrative division

Ottawa

2.64%

Ontario

City

Population

Administrative division

Edmonton

2.45%

Alberta

Canada

29

China Healthcare System • There are three healthcare provision programs in China. • The New Rural Co-operative Medical Scheme (NRCMS) covers some 80% the rural population. • The mandatory Urban Employee Basic Medical Insurance (UEBMI) covers some 300 million people in employment. • The Urban Residents Basic Medical Insurance (URBMI), for those who are unemployed, covers 60% of the 200 million target population. • In 2011, over 95% of the population was covered by one of these three schemes. Reimbursement Policies • The Ministry of Finance is responsible for the total budget. NRCMS and URBMI are mostly funded by central government, provincial governments and patients. • UEBMI is funded through payroll deductions, with employers paying 6% and employees 2%. • Co-payments can be as much as 35% and under NRCMS can account for as much as 90% of the total bill.

Public versus Private • There are three tiers of hospital, with Tier 3 being the highest. Tier 3 and Tier 2 are general hospitals and Tier 1 are community hospitals. Public • Around 90% of hospitals in China are public. • Patients are given prescriptions in hospitals and buy those drugs in hospitals. Private • Private healthcare insurance is usually taken out to supplement state care. • About 30% of China’s urban population has a form of private healthcare. News, Developments and Notes • Language: Mandarin. • Regulator: China’s State Food and Drug Administration. • The government is trying to encourage more patients to go to Tier 1 hospitals to alleviate the burden on higher tier hospitals. • As of 2012, reforms have seen the diagnosis and registration fee increased so the hospitals don’t have to rely on earnings from selling prescribed drugs. However, this has yet to be applied anywhere outside Beijing. • Foreign companies in healthcare services must have Chinese partners that hold at least 30% of total equity.

China

31

China Healthcare System • There are three healthcare provision programs in China. • The New Rural Co-operative Medical Scheme (NRCMS) covers some 80% the rural population. • The mandatory Urban Employee Basic Medical Insurance (UEBMI) covers some 300 million people in employment. • The Urban Residents Basic Medical Insurance (URBMI), for those who are unemployed, covers 60% of the 200 million target population. • In 2011, over 95% of the population was covered by one of these three schemes. Reimbursement Policies • The Ministry of Finance is responsible for the total budget. NRCMS and URBMI are mostly funded by central government, provincial governments and patients. • UEBMI is funded through payroll deductions, with employers paying 6% and employees 2%. • Co-payments can be as much as 35% and under NRCMS can account for as much as 90% of the total bill.

Public versus Private • There are three tiers of hospital, with Tier 3 being the highest. Tier 3 and Tier 2 are general hospitals and Tier 1 are community hospitals. Public • Around 90% of hospitals in China are public. • Patients are given prescriptions in hospitals and buy those drugs in hospitals. Private • Private healthcare insurance is usually taken out to supplement state care. • About 30% of China’s urban population has a form of private healthcare. News, Developments and Notes • Language: Mandarin. • Regulator: China’s State Food and Drug Administration. • The government is trying to encourage more patients to go to Tier 1 hospitals to alleviate the burden on higher tier hospitals. • As of 2012, reforms have seen the diagnosis and registration fee increased so the hospitals don’t have to rely on earnings from selling prescribed drugs. However, this has yet to be applied anywhere outside Beijing. • Foreign companies in healthcare services must have Chinese partners that hold at least 30% of total equity.

China

31

Demographics

1,350,695,000 km2 9,596,961 1,966,612 21,638 5,132,641 Population

Area size

Total doctors

Total hospitals

Total hospital beds

32

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Guangzhou

3.31%

Guangdong

City

Population

Administrative division

Shanghai

2.09%

Shanghai

City

Population

Administrative division

Beijing

1.48%

Beijing

City

Population

Administrative division

Shantou

0.87 %

Guangdong

City

Population

Administrative division

Shenzen

0.77 %

Guangdong

China

33

Demographics

1,350,695,000 km2 9,596,961 1,966,612 21,638 5,132,641 Population

Area size

Total doctors

Total hospitals

Total hospital beds

32

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Guangzhou

3.31%

Guangdong

City

Population

Administrative division

Shanghai

2.09%

Shanghai

City

Population

Administrative division

Beijing

1.48%

Beijing

City

Population

Administrative division

Shantou

0.87 %

Guangdong

City

Population

Administrative division

Shenzen

0.77 %

Guangdong

China

33

Czech Republic Healthcare System • The Czech Republic has a social health system based on compulsory membership in insurance funds. • There are nine decentralized, independent and not-for-profit insurers, which collect the funds. • Eligible residents can choose the insurance fund. • State-guaranteed insurance covers almost 63% of the population, including most of the unemployed. • In 2011, 84.2% of total healthcare expenditure was in the public sector. Reimbursement Policies • Financed through mandatory contributions usually through payroll contributions from both employers and employees. • Out-of-pocket expenses account for over 10% of healthcare expenditure.

Public versus Private Public • Accounts for 71% of hospital beds. Private • Accounts for 29% of hospital beds. News, Developments and Notes • Language: Czech. • Regulator: State Institute for Drug Control. • Patients are free to choose a GP. • The Czech Republic has more physicians per capita than many other OECD countries.

Czech Republic

35

Czech Republic Healthcare System • The Czech Republic has a social health system based on compulsory membership in insurance funds. • There are nine decentralized, independent and not-for-profit insurers, which collect the funds. • Eligible residents can choose the insurance fund. • State-guaranteed insurance covers almost 63% of the population, including most of the unemployed. • In 2011, 84.2% of total healthcare expenditure was in the public sector. Reimbursement Policies • Financed through mandatory contributions usually through payroll contributions from both employers and employees. • Out-of-pocket expenses account for over 10% of healthcare expenditure.

Public versus Private Public • Accounts for 71% of hospital beds. Private • Accounts for 29% of hospital beds. News, Developments and Notes • Language: Czech. • Regulator: State Institute for Drug Control. • Patients are free to choose a GP. • The Czech Republic has more physicians per capita than many other OECD countries.

Czech Republic

35

Demographics

10,513,209 km2 78,866 38,983 357 73,592 Population

Area size

Total doctors

Total hospitals

Total hospital beds

36

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Praha

11.81%

Praha

City

Population

Administrative division

Brno

3.67 %

Jihomoravsky

City

Population

Administrative division

Ostrava

2.85 %

Moravskolezsky

City

Population

Administrative division

Plzen

1.62%

Plzensky

City

Population

Administrative division

Liberec

0.97 %

Liberecky

Czech Republic

37

Demographics

10,513,209 km2 78,866 38,983 357 73,592 Population

Area size

Total doctors

Total hospitals

Total hospital beds

36

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Praha

11.81%

Praha

City

Population

Administrative division

Brno

3.67 %

Jihomoravsky

City

Population

Administrative division

Ostrava

2.85 %

Moravskolezsky

City

Population

Administrative division

Plzen

1.62%

Plzensky

City

Population

Administrative division

Liberec

0.97 %

Liberecky

Czech Republic

37

Denmark Healthcare System • The health system has three administrative levels: state, region and local. • There are five regions and 98 municipalities. • The regions are responsible for delivering both primary and secondary sector health services. • There are two levels: Group 1 members (98% of the population) are attached to one GP and need a referral for specialist visits. Visits to GPs and specialists are free. Group 2 members can choose a GP and visit a specialist without a referral. • In 2010, health expenditure was 85% public and 15% private. Reimbursement Policies • 82% of health spending is funded by state and municipal taxation. • 8% of taxable income goes towards healthcare. • 14% of private expenditure was out-ofpocket spending on drugs. • The state makes block grants to the five regions (80%) and the municipalities (20%). • The regions only cover part of the costs for Group 2 members.

Public versus Private Public • 53 hospitals (Note: several different locations have merged so that many ‘hospitals’ now consist of several geographically distinct units being managed together.) Private • Private hospitals have a capacity of approximately 500 beds, or 2.5% of all hospital beds. • About 30% of the population purchases Voluntary Health Insurance to cover the costs of statutory co-payments. • 13.5% of the population has private insurance, mainly as an employment benefit. News, Developments and Notes • Language: Danish. • Regulators: The Danish Medicines Agency. • If waiting times exceed one month, individuals may seek treatment at private hospitals (even abroad as long as the chosen hospital has an agreement with the regions’ association). • In 2013, Denmark announced a $7 billion plan to build 16 new hospitals, including eight super hospitals.

Denmark

39

Denmark Healthcare System • The health system has three administrative levels: state, region and local. • There are five regions and 98 municipalities. • The regions are responsible for delivering both primary and secondary sector health services. • There are two levels: Group 1 members (98% of the population) are attached to one GP and need a referral for specialist visits. Visits to GPs and specialists are free. Group 2 members can choose a GP and visit a specialist without a referral. • In 2010, health expenditure was 85% public and 15% private. Reimbursement Policies • 82% of health spending is funded by state and municipal taxation. • 8% of taxable income goes towards healthcare. • 14% of private expenditure was out-ofpocket spending on drugs. • The state makes block grants to the five regions (80%) and the municipalities (20%). • The regions only cover part of the costs for Group 2 members.

Public versus Private Public • 53 hospitals (Note: several different locations have merged so that many ‘hospitals’ now consist of several geographically distinct units being managed together.) Private • Private hospitals have a capacity of approximately 500 beds, or 2.5% of all hospital beds. • About 30% of the population purchases Voluntary Health Insurance to cover the costs of statutory co-payments. • 13.5% of the population has private insurance, mainly as an employment benefit. News, Developments and Notes • Language: Danish. • Regulators: The Danish Medicines Agency. • If waiting times exceed one month, individuals may seek treatment at private hospitals (even abroad as long as the chosen hospital has an agreement with the regions’ association). • In 2013, Denmark announced a $7 billion plan to build 16 new hospitals, including eight super hospitals.

Denmark

39

Demographics

5,602,536 km2 42,916 19,056 69 19,609 Population

Area size

Total doctors

Total hospitals

Total hospital beds

40

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Kobenhavn

9.43%

Kobenhavns Kommune

City

Population

Administrative division

Århus

4.34%

Århus

City

Population

Administrative division

Odense

2.99%

Fyn

City

Population

Administrative division

Ålborg

1.83%

Nordjylland

City

Population

Administrative division

Frederiksberg 1.77 %

Århus

Denmark

41

Demographics

5,602,536 km2 42,916 19,056 69 19,609 Population

Area size

Total doctors

Total hospitals

Total hospital beds

40

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Kobenhavn

9.43%

Kobenhavns Kommune

City

Population

Administrative division

Århus

4.34%

Århus

City

Population

Administrative division

Odense

2.99%

Fyn

City

Population

Administrative division

Ålborg

1.83%

Nordjylland

City

Population

Administrative division

Frederiksberg 1.77 %

Århus

Denmark

41

Finland Healthcare System • Every resident in Finland has the right to health services regardless of ability to pay or place of residence. • The 342 municipalities have, by law, the main responsibility for healthcare. They can work alone or in partnership. • There are three levels of cover: municipal healthcare funded by taxes, private healthcare partly funded by National Health Insurance (NHI), and occupational (or preventative) healthcare partly funded by NHI. • Under the Occupational Health Act, employers are required to arrange, at their own expense, professionallevel occupational health services for employees. • The government social insurance agency, known as KELA, is responsible for coordinating the state contribution system. • 75% of total health expenditure was in the public sector while the private sector accounted for 25%.

Public versus Private Public • Hospitals are owned and run by joint authorities. • Mainland Finland has 20 hospital districts. Every municipality must belong to a hospital district. • The largest district is Helsinki and Uusimaa (32 hospitals). • 95% of beds are in public hospitals. Private • 3.5% of beds are private. News, Developments and Notes • Language: Finnish/Swedish. • Regulator: Finnish Medicines Agency. • In 2011, health spending as a share of GDP was lower than in all other Nordic countries, except Iceland (which had the same share). • Healthcare services on the autonomous Åland Islands are provided based on the Act on the Autonomy of Åland.

Reimbursement Policies • The Finnish healthcare service receives 80% of its funding through general taxation, which is collected by local and national government. • Reimbursement is calculated based on a set of fixed fees, which means that citizens may have to pay some of the costs themselves. • Municipalities have the right to levy taxes and to collect out-of-pocket user fees.

Finland

43

Finland Healthcare System • Every resident in Finland has the right to health services regardless of ability to pay or place of residence. • The 342 municipalities have, by law, the main responsibility for healthcare. They can work alone or in partnership. • There are three levels of cover: municipal healthcare funded by taxes, private healthcare partly funded by National Health Insurance (NHI), and occupational (or preventative) healthcare partly funded by NHI. • Under the Occupational Health Act, employers are required to arrange, at their own expense, professionallevel occupational health services for employees. • The government social insurance agency, known as KELA, is responsible for coordinating the state contribution system. • 75% of total health expenditure was in the public sector while the private sector accounted for 25%.

Public versus Private Public • Hospitals are owned and run by joint authorities. • Mainland Finland has 20 hospital districts. Every municipality must belong to a hospital district. • The largest district is Helsinki and Uusimaa (32 hospitals). • 95% of beds are in public hospitals. Private • 3.5% of beds are private. News, Developments and Notes • Language: Finnish/Swedish. • Regulator: Finnish Medicines Agency. • In 2011, health spending as a share of GDP was lower than in all other Nordic countries, except Iceland (which had the same share). • Healthcare services on the autonomous Åland Islands are provided based on the Act on the Autonomy of Åland.

Reimbursement Policies • The Finnish healthcare service receives 80% of its funding through general taxation, which is collected by local and national government. • Reimbursement is calculated based on a set of fixed fees, which means that citizens may have to pay some of the costs themselves. • Municipalities have the right to levy taxes and to collect out-of-pocket user fees.

Finland

43

Demographics

5,421,827 km2 338,424 14,639 380 31,989 Population

Area size

Total doctors

Total hospitals

Total hospital beds

44

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Helsinki

10.65%

Uusimaa

City

Population

Administrative division

Espoo

4.90%

Uusimaa

City

Population

Administrative division

Tampere

3.87 %

Pirkanmaa

City

Population

Administrative division

Vantaa

3.62%

Uusimaa

City

Population

Administrative division

Turku

3.36%

Varsinais

Finland

45

Demographics

5,421,827 km2 338,424 14,639 380 31,989 Population

Area size

Total doctors

Total hospitals

Total hospital beds

44

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Helsinki

10.65%

Uusimaa

City

Population

Administrative division

Espoo

4.90%

Uusimaa

City

Population

Administrative division

Tampere

3.87 %

Pirkanmaa

City

Population

Administrative division

Vantaa

3.62%

Uusimaa

City

Population

Administrative division

Turku

3.36%

Varsinais

Finland

45

France Healthcare System • France has a national social insurance system that covers almost the entire population. It is complex, with allowances and contributions varying according to a person’s status. • It is supported by tax-based financing and voluntary health insurance. • All residents in France are obliged by law to have health insurance. • Most of the population has complementary health insurance to cover their share of the costs from the public and private system. • In 2011, public spending accounted for 76.8% of total healthcare expenditure. Reimbursement Policies • The public health insurance scheme is financed by employer and employee payroll taxes (43%); a national income tax (33%); revenue from taxes levied on tobacco and alcohol (8%); state subsidies (2%); and transfers from other branches of social security (8%). • Out-of-pocket expenses amount to 7.8%. • Most drugs are covered at a rate of 65% but, depending on the type and perceived merit of the product, this can range from 15% to 100%. • Direct payments by households constitute 7.6% of total health expenditures, while 13.8% are paid by health insurance schemes.

Public versus Private Public • 65.5% of all beds are in public hospitals. • Health authorities regulate the size and numbers of hospitals, managing the allocation of technical equipment such as MRI/CT scans, etc. • Public hospitals have specific obligations such as continuity of care and teaching. Private • 34.5% of all beds are in the private sector, of which 20% are in private for-profit hospitals and nearly 15% are in private not-for-profit hospitals. • 68% of GPs are self-employed. • Clinics concentrate on surgical procedures and depend on fee-forservice for funding. News, Developments and Notes • Language: French. • Regulator: National Agency for the Safety of Medicine and Health Products. • In 2011, the number of hospital beds in France was significantly higher than the OECD average. • About 4,500 pharmaceuticals are reimbursable in France, which represents approximately one half of the drugs available.

France

47

France Healthcare System • France has a national social insurance system that covers almost the entire population. It is complex, with allowances and contributions varying according to a person’s status. • It is supported by tax-based financing and voluntary health insurance. • All residents in France are obliged by law to have health insurance. • Most of the population has complementary health insurance to cover their share of the costs from the public and private system. • In 2011, public spending accounted for 76.8% of total healthcare expenditure. Reimbursement Policies • The public health insurance scheme is financed by employer and employee payroll taxes (43%); a national income tax (33%); revenue from taxes levied on tobacco and alcohol (8%); state subsidies (2%); and transfers from other branches of social security (8%). • Out-of-pocket expenses amount to 7.8%. • Most drugs are covered at a rate of 65% but, depending on the type and perceived merit of the product, this can range from 15% to 100%. • Direct payments by households constitute 7.6% of total health expenditures, while 13.8% are paid by health insurance schemes.

Public versus Private Public • 65.5% of all beds are in public hospitals. • Health authorities regulate the size and numbers of hospitals, managing the allocation of technical equipment such as MRI/CT scans, etc. • Public hospitals have specific obligations such as continuity of care and teaching. Private • 34.5% of all beds are in the private sector, of which 20% are in private for-profit hospitals and nearly 15% are in private not-for-profit hospitals. • 68% of GPs are self-employed. • Clinics concentrate on surgical procedures and depend on fee-forservice for funding. News, Developments and Notes • Language: French. • Regulator: National Agency for the Safety of Medicine and Health Products. • In 2011, the number of hospital beds in France was significantly higher than the OECD average. • About 4,500 pharmaceuticals are reimbursable in France, which represents approximately one half of the drugs available.

France

47

Demographics

63,460,000 km2 640,679 214,558 4,171 418,836 Population

Area size

Total doctors

Total hospitals

Total hospital beds

48

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Paris

3.35%

Paris

City

Population

Administrative division

Marseille

1.26%

Bouches du Rh么ne

City

Population

Administrative division

Lyon

0.70%

Rh么ne

City

Population

Administrative division

Toulouse

0.62%

Haute Garonne

City

Population

Administrative division

Nice

0.54%

Alpes Maritimes

France

49

Demographics

63,460,000 km2 640,679 214,558 4,171 418,836 Population

Area size

Total doctors

Total hospitals

Total hospital beds

48

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Paris

3.35%

Paris

City

Population

Administrative division

Marseille

1.26%

Bouches du Rh么ne

City

Population

Administrative division

Lyon

0.70%

Rh么ne

City

Population

Administrative division

Toulouse

0.62%

Haute Garonne

City

Population

Administrative division

Nice

0.54%

Alpes Maritimes

France

49

Germany Healthcare System • Responsibility for the healthcare system is shared between the states, the federal government and civil society organizations. • About 87% of the population is covered by statutory health insurance offered by the statutory sickness funds. • 10% of people have private health insurance. • 2% are covered by other governmental schemes, such as the scheme for soldiers. • About 9% of the population purchases supplementary health insurance (SHI) to cover items that aren’t part of the standard benefit package. • In 2011, the public sector accounted for 76.5% of total healthcare expenditure. Reimbursement Policies • Sickness fund contributions are set by the government. The contribution rate of 15.5% is split between employers and employees. Employees currently pay 8.2% and employers 7.3%. • Out-of-pocket payments (13.3%), are mostly spent on OTC medicines and co-payments for prescription drugs, outpatient visits and hospital stays. • All prescription drugs – including newly licensed ones – are covered unless explicitly excluded by law. • If a physician issues a prescription for a specific medicine without excluding substitution, a pharmacist must dispense the prescribed medicine or one of the three cheapest alternatives. • Pharmacists are paid a flat amount for filling prescriptions, so have no financial incentive to dispense the more expensive drugs.

Public versus Private Public • 53% of hospitals are public. • Regardless of ownership, hospitals are staffed principally by salaried doctors. • The 16 state governments determine hospital capacity. Private • 39% are not-for-profit private hospitals. • 8% are for-profit hospitals. • Based on risk-related premiums, with separate premiums for dependents. Risk is assessed upon entry and contracts are based on lifetime underwriting. News, Developments and Notes • Language: German. • Regulator: Federal Institute for Drugs and Medical Devices. • German law requires everyone living in Germany to be insured for at least hospital and outpatient medical treatment. • Anyone earning more than €49,500 per annum has the option of purchasing a private health insurance plan, although upwards of 85% opt to remain with SHI. • Germany has one of the highest levels of hospital beds per capita amongst OECD countries.

Germany

51

Germany Healthcare System • Responsibility for the healthcare system is shared between the states, the federal government and civil society organizations. • About 87% of the population is covered by statutory health insurance offered by the statutory sickness funds. • 10% of people have private health insurance. • 2% are covered by other governmental schemes, such as the scheme for soldiers. • About 9% of the population purchases supplementary health insurance (SHI) to cover items that aren’t part of the standard benefit package. • In 2011, the public sector accounted for 76.5% of total healthcare expenditure. Reimbursement Policies • Sickness fund contributions are set by the government. The contribution rate of 15.5% is split between employers and employees. Employees currently pay 8.2% and employers 7.3%. • Out-of-pocket payments (13.3%), are mostly spent on OTC medicines and co-payments for prescription drugs, outpatient visits and hospital stays. • All prescription drugs – including newly licensed ones – are covered unless explicitly excluded by law. • If a physician issues a prescription for a specific medicine without excluding substitution, a pharmacist must dispense the prescribed medicine or one of the three cheapest alternatives. • Pharmacists are paid a flat amount for filling prescriptions, so have no financial incentive to dispense the more expensive drugs.

Public versus Private Public • 53% of hospitals are public. • Regardless of ownership, hospitals are staffed principally by salaried doctors. • The 16 state governments determine hospital capacity. Private • 39% are not-for-profit private hospitals. • 8% are for-profit hospitals. • Based on risk-related premiums, with separate premiums for dependents. Risk is assessed upon entry and contracts are based on lifetime underwriting. News, Developments and Notes • Language: German. • Regulator: Federal Institute for Drugs and Medical Devices. • German law requires everyone living in Germany to be insured for at least hospital and outpatient medical treatment. • Anyone earning more than €49,500 per annum has the option of purchasing a private health insurance plan, although upwards of 85% opt to remain with SHI. • Germany has one of the highest levels of hospital beds per capita amongst OECD countries.

Germany

51

Demographics

80,585,700 km2 357,021 451,280 2,017 668,861 Population

Area size

Total doctors

Total hospitals

Total hospital beds

52

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Berlin

4.31%

Berlin

City

Population

Administrative division

Hamburg

2.23%

Hamburg

City

Population

Administrative division

MĂźnchen

1.69%

Bayern

City

Population

Administrative division

KĂśln

1.23%

NordrheinWestfallen

City

Population

Administrative division

Frankfurt

0.85%

Hessen

Germany

53

Demographics

80,585,700 km2 357,021 451,280 2,017 668,861 Population

Area size

Total doctors

Total hospitals

Total hospital beds

52

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Berlin

4.31%

Berlin

City

Population

Administrative division

Hamburg

2.23%

Hamburg

City

Population

Administrative division

MĂźnchen

1.69%

Bayern

City

Population

Administrative division

KĂśln

1.23%

NordrheinWestfallen

City

Population

Administrative division

Frankfurt

0.85%

Hessen

Germany

53

Greece Healthcare System • The Greek system is a mixture of publicprivate provision of healthcare services. • The National Health System comprises public hospitals, health centers and emergency care. • The Social Security Institution (IKA) and other social insurance funds offer different insurance coverage. Approximately 30 social health insurance funds provide coverage to about 97% of the population. IKA is the largest fund, covering 50% of the population. • The private sector tends to comprise diagnostic centers, private clinics, laboratories, etc. • Health insurance in Greece is compulsory, with people being designated a fund linked to their occupation. • Employees must have worked at least 50 days in the last year or within the preceding 15 months (the last three months are not taken into account) to benefit from IKA insurance. • In 2011, 65% of total healthcare expenditure goes on the public sector. Reimbursement Policies • Healthcare is funded by general taxation, social premiums and private premiums. The tax system contributes 29.1% of total health expenditure while health insurance accounts for 31.2%. • Medicines are vastly subsidized – only 25% of the cost of the prescription is charged. • Out-of-pocket expenditure constitutes about 37% of total health expenditure.

Public versus Private Public • The availability of public hospitals is limited to certain areas, normally clustering in big cities. • Although they can be consulted directly, public hospital residents usually have long waiting lists. • Around 72% of beds are in public hospitals. • Doctors working in public hospitals and health centers are not allowed to engage in private practice. Private • About 12% of the population has private insurance. • Private hospitals account for 28% of all beds. News, Developments and Notes • Language: Greek. • Regulator: National Organization for Medicines. • Despite much upheaval, there remain more physicians per capita in Greece than in any other OECD country. • Under-the-table payments are a continuing problem. • While patients can’t choose their insurer, there is a large degree of choice of provider.

Greece

55

Greece Healthcare System • The Greek system is a mixture of publicprivate provision of healthcare services. • The National Health System comprises public hospitals, health centers and emergency care. • The Social Security Institution (IKA) and other social insurance funds offer different insurance coverage. Approximately 30 social health insurance funds provide coverage to about 97% of the population. IKA is the largest fund, covering 50% of the population. • The private sector tends to comprise diagnostic centers, private clinics, laboratories, etc. • Health insurance in Greece is compulsory, with people being designated a fund linked to their occupation. • Employees must have worked at least 50 days in the last year or within the preceding 15 months (the last three months are not taken into account) to benefit from IKA insurance. • In 2011, 65% of total healthcare expenditure goes on the public sector. Reimbursement Policies • Healthcare is funded by general taxation, social premiums and private premiums. The tax system contributes 29.1% of total health expenditure while health insurance accounts for 31.2%. • Medicines are vastly subsidized – only 25% of the cost of the prescription is charged. • Out-of-pocket expenditure constitutes about 37% of total health expenditure.

Public versus Private Public • The availability of public hospitals is limited to certain areas, normally clustering in big cities. • Although they can be consulted directly, public hospital residents usually have long waiting lists. • Around 72% of beds are in public hospitals. • Doctors working in public hospitals and health centers are not allowed to engage in private practice. Private • About 12% of the population has private insurance. • Private hospitals account for 28% of all beds. News, Developments and Notes • Language: Greek. • Regulator: National Organization for Medicines. • Despite much upheaval, there remain more physicians per capita in Greece than in any other OECD country. • Under-the-table payments are a continuing problem. • While patients can’t choose their insurer, there is a large degree of choice of provider.

Greece

55

Demographics

10,815,197 km2 131,957 65,973 337 35,000 Population

Area size

Total doctors

Total hospitals

Total hospital beds

56

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Athens

28.42 %

Attica

City

Population

Administrative division

ThessalonĂ­ki

7.31%

Macedonia

City

Population

Administrative division

Patras

1.94%

West Greece

City

Population

Administrative division

Heraklion

1.60%

Crete

City

Population

Administrative division

Larissa

1.51%

Thessaly

Greece

57

Demographics

10,815,197 km2 131,957 65,973 337 35,000 Population

Area size

Total doctors

Total hospitals

Total hospital beds

56

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Athens

28.42 %

Attica

City

Population

Administrative division

ThessalonĂ­ki

7.31%

Macedonia

City

Population

Administrative division

Patras

1.94%

West Greece

City

Population

Administrative division

Heraklion

1.60%

Crete

City

Population

Administrative division

Larissa

1.51%

Thessaly

Greece

57

Hungary Healthcare System • The system is based on social health insurance that covers virtually the entire population. • It has undergone extensive privatization and its funding is now predominantly through the Health Insurance Fund. • Municipalities are responsible for providing primary care, while responsibility for secondary and tertiary services is shared between municipalities, counties and central government. • Membership is compulsory for all those living in Hungary. • Voluntary health insurance (or top ups) exist in Hungary but only represent a negligible source of healthcare financing. • In 2011, public expenditure accounted for 65% of total healthcare expenditure. Reimbursement Policies • The National Health Insurance Fund Administration is responsible for healthcare financing. • Healthcare is financed by health insurance contributions. Employees pay 3% of their total income, while employers pay 15% of the employee’s gross salary plus a lump sum tax or ‘healthcare contribution’. • In 2008, contributions constituted 71% of all revenues of the Health Insurance Fund. • Out-of-pocket payments account for about 18% of expenditure.

Public versus Private Public • Over 76% of hospital beds are in the public sector. • Most public hospitals are owned by regional and local authorities; university and big hospitals for specialized treatments are still owned by the state. Private • 23% of private hospitals are not for profit with the remainder profit making. • In secondary outpatient care, many doctors offer part-time private clinics in addition to their public sector work. • Some private polyclinics simply charge patients directly for services. News, Developments and Notes • Language: Hungarian. • Regulator: National Institute of Pharmacy. • Due to the low wages of medical staff, there is also a tradition of paying gratitude money after operations or childbirth. • Patients can choose their GP.

Hungary

59

Hungary Healthcare System • The system is based on social health insurance that covers virtually the entire population. • It has undergone extensive privatization and its funding is now predominantly through the Health Insurance Fund. • Municipalities are responsible for providing primary care, while responsibility for secondary and tertiary services is shared between municipalities, counties and central government. • Membership is compulsory for all those living in Hungary. • Voluntary health insurance (or top ups) exist in Hungary but only represent a negligible source of healthcare financing. • In 2011, public expenditure accounted for 65% of total healthcare expenditure. Reimbursement Policies • The National Health Insurance Fund Administration is responsible for healthcare financing. • Healthcare is financed by health insurance contributions. Employees pay 3% of their total income, while employers pay 15% of the employee’s gross salary plus a lump sum tax or ‘healthcare contribution’. • In 2008, contributions constituted 71% of all revenues of the Health Insurance Fund. • Out-of-pocket payments account for about 18% of expenditure.

Public versus Private Public • Over 76% of hospital beds are in the public sector. • Most public hospitals are owned by regional and local authorities; university and big hospitals for specialized treatments are still owned by the state. Private • 23% of private hospitals are not for profit with the remainder profit making. • In secondary outpatient care, many doctors offer part-time private clinics in addition to their public sector work. • Some private polyclinics simply charge patients directly for services. News, Developments and Notes • Language: Hungarian. • Regulator: National Institute of Pharmacy. • Due to the low wages of medical staff, there is also a tradition of paying gratitude money after operations or childbirth. • Patients can choose their GP.

Hungary

59

Demographics

9,908,798 km2 93,030 33,769 167 71,343 Population

Area size

Total doctors

Total hospitals

Total hospital beds

60

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Budapest

17.56%

Budapest

City

Population

Administrative division

Debrecen

2.10%

Hajdú- Bihar

City

Population

Administrative division

Szeged

1.72%

Csongrád

City

Population

Administrative division

Miskolc

1.68%

Borsod- AbaújZemplén

City

Population

Administrative division

Pécs

1.58%

Baranya

Hungary

61

Demographics

9,908,798 km2 93,030 33,769 167 71,343 Population

Area size

Total doctors

Total hospitals

Total hospital beds

60

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Budapest

17.56%

Budapest

City

Population

Administrative division

Debrecen

2.10%

Hajdú- Bihar

City

Population

Administrative division

Szeged

1.72%

Csongrád

City

Population

Administrative division

Miskolc

1.68%

Borsod- AbaújZemplén

City

Population

Administrative division

Pécs

1.58%

Baranya

Hungary

61

India Healthcare System • The healthcare system in India is overseen by the Ministry of Health and Family Welfare. • While India does have a universal healthcare system, it is dominated by private healthcare providers. • Less than 15% of the Indian population is covered under some form of health insurance, including governmentsupported schemes. • The National Rural Health Mission was set up to provide accessible, affordable and good-quality healthcare to the rural population, which makes up 72% of the population yet only has access to onethird of the beds. • Health insurance only covers hospitalization and emergency costs. • Only 31% of total health expenditure was funded by public sources in 2011.

Public versus Private Public • In 2006, out-of-pocket expenditures accounted for over 75% of the total healthcare spend. • The cost of treatment at private healthcare facilities is between two and nine times higher than at public facilities.

Reimbursement Policies • In 2006, out-of-pocket expenditures accounted for over 75% of the total healthcare spend. • The cost of treatment at private healthcare facilities is between two and nine times higher than at public facilities.

News, Developments and Notes • Language: Hindi, English (plus 21 additional official languages). • Regulator: Central Drugs Standard Control Organization. • India has one of the lowest doctor per capita ratios in the world. • There is currently a bill going through Parliament seeking to amend the Drug and Cosmetics Act and set up a Central Drugs Authority. • The healthcare system includes Ayurvedic hospitals. • Private hospitals have a bed quota that they must reserve to treat poor patients.

Private • 70% of households in urban areas and 63% in rural areas rely on the private medical sector. • 75% of physicians in both urban and rural settings are in the private sector. • Nearly three out of four hospital beds are in private, urban hospitals. • Most of the private facilities are confined to the state capitals or Tier I cities. Few providers have made inroads in Tier II and Tier III cities.

India

63

India Healthcare System • The healthcare system in India is overseen by the Ministry of Health and Family Welfare. • While India does have a universal healthcare system, it is dominated by private healthcare providers. • Less than 15% of the Indian population is covered under some form of health insurance, including governmentsupported schemes. • The National Rural Health Mission was set up to provide accessible, affordable and good-quality healthcare to the rural population, which makes up 72% of the population yet only has access to onethird of the beds. • Health insurance only covers hospitalization and emergency costs. • Only 31% of total health expenditure was funded by public sources in 2011.

Public versus Private Public • In 2006, out-of-pocket expenditures accounted for over 75% of the total healthcare spend. • The cost of treatment at private healthcare facilities is between two and nine times higher than at public facilities.

Reimbursement Policies • In 2006, out-of-pocket expenditures accounted for over 75% of the total healthcare spend. • The cost of treatment at private healthcare facilities is between two and nine times higher than at public facilities.

News, Developments and Notes • Language: Hindi, English (plus 21 additional official languages). • Regulator: Central Drugs Standard Control Organization. • India has one of the lowest doctor per capita ratios in the world. • There is currently a bill going through Parliament seeking to amend the Drug and Cosmetics Act and set up a Central Drugs Authority. • The healthcare system includes Ayurvedic hospitals. • Private hospitals have a bed quota that they must reserve to treat poor patients.

Private • 70% of households in urban areas and 63% in rural areas rely on the private medical sector. • 75% of physicians in both urban and rural settings are in the private sector. • Nearly three out of four hospital beds are in private, urban hospitals. • Most of the private facilities are confined to the state capitals or Tier I cities. Few providers have made inroads in Tier II and Tier III cities.

India

63

Demographics

1,210,193,422 km2 3,287,590 786,626 12,760 576,793 Population

Area size

Total doctors

Total hospitals

Total hospital beds

64

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Mumbai

1.03%

Maharashtra

City

Population

Administrative division

Delhi

0.91%

Delhi

City

Population

Administrative division

Bangalore

0.70%

Karnataka

City

Population

Administrative division

Hyderabad

0.56%

Andhra Pradesh

City

Population

Administrative division

Ahmedabad

0.46%

Gujarat

India

65

Demographics

1,210,193,422 km2 3,287,590 786,626 12,760 576,793 Population

Area size

Total doctors

Total hospitals

Total hospital beds

64

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Mumbai

1.03%

Maharashtra

City

Population

Administrative division

Delhi

0.91%

Delhi

City

Population

Administrative division

Bangalore

0.70%

Karnataka

City

Population

Administrative division

Hyderabad

0.56%

Andhra Pradesh

City

Population

Administrative division

Ahmedabad

0.46%

Gujarat

India

65

Ireland Healthcare System • Ireland has a comprehensive, governmentfunded public healthcare system. • Delivered by the Health Service Executive (HSE), it is available to all but not free to all. • Anyone who has lived in Ireland for at least one year has either full eligibility (Category 1) or limited eligibility (Category 2) for health services. • Eligibility is means tested rather than relying on social insurance contributions or tax payments. • Over 30% of the population are Category 1 patients and they receive a medical card allowing them to access free services. • Category 2 patients must contribute towards most services. • 50% of the population has voluntary health insurance to gain more immediate access to some hospital interventions. • In 2011, 67% of total health expenditure was in the public sector. Reimbursement Policies • The primary source of healthcare funding is general taxation, accounting for 75% of expenditure. • 13% of expenditure is on out-of-pocket payments for primary care services such as GP visits, drugs and private hospital treatment. • Pay-Related Social Insurance (PRSI) constitutes only 1% of healthcare financing in Ireland. • In 2011, an income-led, healthcarerelated tax called Universal Social Charge was imposed of between 4% and 7%; those earning less than €10,036 are exempt.

Public versus Private • There are three types of hospital: HSE hospitals (owned and funded by the state), voluntary public hospitals (run by private bodies and mostly funded by the government) and fully private hospitals. Public • In 2011, there were at least 57 acute hospitals and 28 voluntary public hospitals – including university teaching hospitals. Private • 21 private hospitals. • Approximately 50% of the Irish population has private health insurance cover. • Some of the beds in acute public hospitals are designated for use by private patients. News, Developments and Notes • Language: Irish Gaelic/English. • Regulator: Irish Medicines Board. • Following the economic crisis, Ireland saw a significant reduction in the public share of health funding. This was brought about, in part, by measures introduced to increase out-of-pocket costs, including increases in the share of direct payments for prescribed medicines.

Ireland

67

Ireland Healthcare System • Ireland has a comprehensive, governmentfunded public healthcare system. • Delivered by the Health Service Executive (HSE), it is available to all but not free to all. • Anyone who has lived in Ireland for at least one year has either full eligibility (Category 1) or limited eligibility (Category 2) for health services. • Eligibility is means tested rather than relying on social insurance contributions or tax payments. • Over 30% of the population are Category 1 patients and they receive a medical card allowing them to access free services. • Category 2 patients must contribute towards most services. • 50% of the population has voluntary health insurance to gain more immediate access to some hospital interventions. • In 2011, 67% of total health expenditure was in the public sector. Reimbursement Policies • The primary source of healthcare funding is general taxation, accounting for 75% of expenditure. • 13% of expenditure is on out-of-pocket payments for primary care services such as GP visits, drugs and private hospital treatment. • Pay-Related Social Insurance (PRSI) constitutes only 1% of healthcare financing in Ireland. • In 2011, an income-led, healthcarerelated tax called Universal Social Charge was imposed of between 4% and 7%; those earning less than €10,036 are exempt.

Public versus Private • There are three types of hospital: HSE hospitals (owned and funded by the state), voluntary public hospitals (run by private bodies and mostly funded by the government) and fully private hospitals. Public • In 2011, there were at least 57 acute hospitals and 28 voluntary public hospitals – including university teaching hospitals. Private • 21 private hospitals. • Approximately 50% of the Irish population has private health insurance cover. • Some of the beds in acute public hospitals are designated for use by private patients. News, Developments and Notes • Language: Irish Gaelic/English. • Regulator: Irish Medicines Board. • Following the economic crisis, Ireland saw a significant reduction in the public share of health funding. This was brought about, in part, by measures introduced to increase out-of-pocket costs, including increases in the share of direct payments for prescribed medicines.

Ireland

67

Demographics

6,399,115 km2 84,421 17,278 176 20,477 Population

Area size

Total doctors

Total hospitals

Total hospital beds

68

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Dublin

17.36 %

Dublin

City

Population

Administrative division

Cork

3.10%

Cork

City

Population

Administrative division

Limerick

1.43%

Limerick

City

Population

Administrative division

Galway

1.20%

Galway

City

Population

Administrative division

Waterford

0.81%

Waterford

Ireland

69

Demographics

6,399,115 km2 84,421 17,278 176 20,477 Population

Area size

Total doctors

Total hospitals

Total hospital beds

68

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Dublin

17.36 %

Dublin

City

Population

Administrative division

Cork

3.10%

Cork

City

Population

Administrative division

Limerick

1.43%

Limerick

City

Population

Administrative division

Galway

1.20%

Galway

City

Population

Administrative division

Waterford

0.81%

Waterford

Ireland

69

Italy Healthcare System • The system offers universal coverage through the National Health Service run by the governments of the regions. • Working for the regions, local health units (ASLs) are responsible for the delivery of services such as primary care, hospital care, public health, occupational health and healthcare related to social care. • About 15% of the population has complimentary private health insurance either individually or via their employers (who are obliged to pay for the health insurance). • 77.8% of total healthcare expenditure was in the public sector in 2011.

Public versus Private Public • 77% of beds are in the public sector. • There are 669 public facilities, which provide both outpatient and inpatient services. • ASLs also contract out services to hundreds of private hospitals, especially not-for-profit institutions.

Reimbursement Policies • The system is financed by general taxation, including indirect taxation such a VAT and regional levies. • Prescription drugs are divided into three tiers according to clinical effectiveness and cost-effectiveness. The first tier is reimbursed in all cases, the second tier is only reimbursed in hospitals, and the third is not covered at all. • 21% of healthcare costs are paid out-ofpocket by patients.

News, Developments and Notes • Language: Italian. • Regulator: Italian Medicines Agency. • The number of physicians per capita in Italy is well above the OECD average. • Allowing regions to generate their own additional revenue leads to interregional financing differences. • Patients can choose their GP. • Doctors have a maximum number of patients allowed (1,500 for GPs and 800 for pediatricians).

Private • 23% of beds are in the private sector. • 15% of the population has some form of private health insurance. • About 74% of policies are purchased by individuals and 26% are purchased by groups.

Italy

71

Italy Healthcare System • The system offers universal coverage through the National Health Service run by the governments of the regions. • Working for the regions, local health units (ASLs) are responsible for the delivery of services such as primary care, hospital care, public health, occupational health and healthcare related to social care. • About 15% of the population has complimentary private health insurance either individually or via their employers (who are obliged to pay for the health insurance). • 77.8% of total healthcare expenditure was in the public sector in 2011.

Public versus Private Public • 77% of beds are in the public sector. • There are 669 public facilities, which provide both outpatient and inpatient services. • ASLs also contract out services to hundreds of private hospitals, especially not-for-profit institutions.

Reimbursement Policies • The system is financed by general taxation, including indirect taxation such a VAT and regional levies. • Prescription drugs are divided into three tiers according to clinical effectiveness and cost-effectiveness. The first tier is reimbursed in all cases, the second tier is only reimbursed in hospitals, and the third is not covered at all. • 21% of healthcare costs are paid out-ofpocket by patients.

News, Developments and Notes • Language: Italian. • Regulator: Italian Medicines Agency. • The number of physicians per capita in Italy is well above the OECD average. • Allowing regions to generate their own additional revenue leads to interregional financing differences. • Patients can choose their GP. • Doctors have a maximum number of patients allowed (1,500 for GPs and 800 for pediatricians).

Private • 23% of beds are in the private sector. • 15% of the population has some form of private health insurance. • About 74% of policies are purchased by individuals and 26% are purchased by groups.

Italy

71

Demographics

59,685,227 km2 301,338 226,923 1,283 208,898 Population

Area size

Total doctors

Total hospitals

Total hospital beds

72

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Roma

4.40%

Lazio

City

Population

Administrative division

Milano

2.09%

Lombardia

City

Population

Administrative division

Napoli

1.62%

Campania

City

Population

Administrative division

Torino

1.47 %

Piemonte

City

Population

Administrative division

Palermo

1.11%

Sicilia

Italy

73

Demographics

59,685,227 km2 301,338 226,923 1,283 208,898 Population

Area size

Total doctors

Total hospitals

Total hospital beds

72

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Roma

4.40%

Lazio

City

Population

Administrative division

Milano

2.09%

Lombardia

City

Population

Administrative division

Napoli

1.62%

Campania

City

Population

Administrative division

Torino

1.47 %

Piemonte

City

Population

Administrative division

Palermo

1.11%

Sicilia

Italy

73

Japan Healthcare System • There are three types of insurance cover in Japan.The National Health Insurance (NHI) scheme, the Employee Health Insurance (EHI) and the mutual-aid association. • Most public health services are administered by local governments (prefecture and municipal) and delivered by public health centers at the prefecture level and municipal health centers at the municipal level. • EHI covers individuals in medium to large companies, national and local government, and private schools. Small businesses are covered through a government-run plan within the EHI. • Foreigners who live in Japan for over a year must join the NHI unless they are covered by their employer’s health insurance scheme. • Health insurance is mandatory for all company employees, including foreigners. • Mutual-aid is for government employers and private school teachers. • In Japan, 82% of total health expenditure was funded by public sources in 2010.

Public versus Private Public • There are municipal and prefectural hospitals. • 20% of hospitals are public, mostly teaching hospitals. Private • 80% of hospitals are privately owned. News, Developments and Notes • Language: Japanese. • Regulator: Pharmaceuticals and Medical Devices Agency. • Japan has fewer physicians per capita than most other OECD countries. • Government policies limit the number of new entrants in medical schools. • The system includes more than 4,000 public and private payers.

Reimbursement Policies • NHI is funded by the government and through contributions. The amount contributed is calculated annually according to income and the number of people in a family. • Premiums for EHI schemes are calculated according to salary. • The EHI and NHI cover up to 70% of medical costs on average. • Out-of-pocket payments account for just over 16% of healthcare expenditure. • Patients are required to pay 30% of the cost of drugs. • The list of reimbursable drugs includes nearly 14,000 products. Japan

75

Japan Healthcare System • There are three types of insurance cover in Japan.The National Health Insurance (NHI) scheme, the Employee Health Insurance (EHI) and the mutual-aid association. • Most public health services are administered by local governments (prefecture and municipal) and delivered by public health centers at the prefecture level and municipal health centers at the municipal level. • EHI covers individuals in medium to large companies, national and local government, and private schools. Small businesses are covered through a government-run plan within the EHI. • Foreigners who live in Japan for over a year must join the NHI unless they are covered by their employer’s health insurance scheme. • Health insurance is mandatory for all company employees, including foreigners. • Mutual-aid is for government employers and private school teachers. • In Japan, 82% of total health expenditure was funded by public sources in 2010.

Public versus Private Public • There are municipal and prefectural hospitals. • 20% of hospitals are public, mostly teaching hospitals. Private • 80% of hospitals are privately owned. News, Developments and Notes • Language: Japanese. • Regulator: Pharmaceuticals and Medical Devices Agency. • Japan has fewer physicians per capita than most other OECD countries. • Government policies limit the number of new entrants in medical schools. • The system includes more than 4,000 public and private payers.

Reimbursement Policies • NHI is funded by the government and through contributions. The amount contributed is calculated annually according to income and the number of people in a family. • Premiums for EHI schemes are calculated according to salary. • The EHI and NHI cover up to 70% of medical costs on average. • Out-of-pocket payments account for just over 16% of healthcare expenditure. • Patients are required to pay 30% of the cost of drugs. • The list of reimbursable drugs includes nearly 14,000 products. Japan

75

Demographics

126,659,683 km2 377,944 271,052 8,862 1,735,199 Population

Area size

Total doctors

Total hospitals

Total hospital beds

76

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Tokyo

6.99%

Kantō

City

Population

Administrative division

Yokohama

2.88%

Kantō

City

Population

Administrative division

Osaka

2.08%

Kansai

City

Population

Administrative division

Nagoya

1.77 %

Chūbu

City

Population

Administrative division

Sapporo

1.49%

Hokkaidō

Japan

77

Demographics

126,659,683 km2 377,944 271,052 8,862 1,735,199 Population

Area size

Total doctors

Total hospitals

Total hospital beds

76

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Tokyo

6.99%

Kantō

City

Population

Administrative division

Yokohama

2.88%

Kantō

City

Population

Administrative division

Osaka

2.08%

Kansai

City

Population

Administrative division

Nagoya

1.77 %

Chūbu

City

Population

Administrative division

Sapporo

1.49%

Hokkaidō

Japan

77

Luxembourg Healthcare System • Luxembourg has free access to basic healthcare for all citizens. • 98% of the population is covered by compulsory public health insurance. • Luxembourg’s health service is overseen by the Union of Sickness Funds. • All medical fees in the country are decided by the Caisse de Maladie. • In 2011, 84% of health spending was funded by public sources. Reimbursement Policies • Healthcare is financed through contributions via the various social partners (sickness funds) and a state allocation of about 38%. • Most employees and their employers pay about 5% of the salary each. • Reimbursement varies from 80% to 100% for services and, depending on the type of drug, from 0 to 100%. • 59% of the population take out voluntary private insurance to cover out-of-pocket costs.

Public versus Private Public • 50% hospitals but 40% of beds are in public hospitals. Private • 50% hospitals but 60% of beds are in private hospitals. • 1.1% of the population appears to rely on private primary health insurance. News, Developments and Notes • Language: French. • Regulator: Ministry of Health. • The various public health insurance funds were recently merged into the general Caisse Nationale de Santé (National Health Fund). • Luxembourg and Germany are the only countries in the EU with compulsory long-term care insurance. • Free choice of GP, specialist and hospital.

Luxembourg

79

Luxembourg Healthcare System • Luxembourg has free access to basic healthcare for all citizens. • 98% of the population is covered by compulsory public health insurance. • Luxembourg’s health service is overseen by the Union of Sickness Funds. • All medical fees in the country are decided by the Caisse de Maladie. • In 2011, 84% of health spending was funded by public sources. Reimbursement Policies • Healthcare is financed through contributions via the various social partners (sickness funds) and a state allocation of about 38%. • Most employees and their employers pay about 5% of the salary each. • Reimbursement varies from 80% to 100% for services and, depending on the type of drug, from 0 to 100%. • 59% of the population take out voluntary private insurance to cover out-of-pocket costs.

Public versus Private Public • 50% hospitals but 40% of beds are in public hospitals. Private • 50% hospitals but 60% of beds are in private hospitals. • 1.1% of the population appears to rely on private primary health insurance. News, Developments and Notes • Language: French. • Regulator: Ministry of Health. • The various public health insurance funds were recently merged into the general Caisse Nationale de Santé (National Health Fund). • Luxembourg and Germany are the only countries in the EU with compulsory long-term care insurance. • Free choice of GP, specialist and hospital.

Luxembourg

79

Demographics

537,853 km2 2,586 1,608 17 2,904 Population

Area size

Total doctors

Total hospitals

Total hospital beds

80

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Luxembourg City

15.41%

Luxembourg

City

Population

Administrative division

Esch-surAlzette

5.67%

Esch-sur-Alzette

City

Population

Administrative division

Dudelange

3.62%

Esch-sur-Alzette

City

Population

Administrative division

Schifflange

1.63%

Esch-sur-Alzette

City

Population

Administrative division

Bettembourg

1.49%

Esch-sur-Alzette

Luxembourg

81

Demographics

537,853 km2 2,586 1,608 17 2,904 Population

Area size

Total doctors

Total hospitals

Total hospital beds

80

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Luxembourg City

15.41%

Luxembourg

City

Population

Administrative division

Esch-surAlzette

5.67%

Esch-sur-Alzette

City

Population

Administrative division

Dudelange

3.62%

Esch-sur-Alzette

City

Population

Administrative division

Schifflange

1.63%

Esch-sur-Alzette

City

Population

Administrative division

Bettembourg

1.49%

Esch-sur-Alzette

Luxembourg

81

Mexico Healthcare System • Mexico has a universal healthcare system, run by social security (IMSS), which is free at the point of delivery. • IMSS applies to private sector workers and covers over 59 million people. • About 17 million state employees have a separate parallel scheme. • Over 51 million people who don’t qualify for the IMSS are covered by Seguro Popular (Popular Health Insurance). • The 32 state governments are responsible for spending 89% of total resources of the Seguro Popular. • In 2010, 47% of health spending was paid from public sources, the lowest public share of all OECD countries. • Private spending accounts for 51% of total health expenditure. • In 2011, 98% of Mexican residents had some form of health coverage. Reimbursement Policies • IMSS is financed by contributions from employees and employers, with additional funding from the government. • Seguro Popular is funded entirely by the government. • Approximately 47% of health spending in Mexico is private and most of it is out-of-pocket. • The public sector is supposed to purchase only those drugs included in a basic list of interchangeable, bioequivalent generics.

Public versus Private Public • There are over 1,570 public hospitals. • IMSS runs its own primary care units and state hospitals, although the quality varies considerably. • State employees have their own clinics and hospitals. Private • About 5% of the population have private health insurance. • There are nearly 3,150 private hospitals. • The Mexican private sector accounts for 34% of total hospital beds. • Only 15% of private hospitals have more than 15 beds. News, Developments and Notes • Language: Spanish. • Regulator: Commission for the Protection against Sanitary Risks. • The quest for universal health coverage only began a decade ago.

Mexico

83

Mexico Healthcare System • Mexico has a universal healthcare system, run by social security (IMSS), which is free at the point of delivery. • IMSS applies to private sector workers and covers over 59 million people. • About 17 million state employees have a separate parallel scheme. • Over 51 million people who don’t qualify for the IMSS are covered by Seguro Popular (Popular Health Insurance). • The 32 state governments are responsible for spending 89% of total resources of the Seguro Popular. • In 2010, 47% of health spending was paid from public sources, the lowest public share of all OECD countries. • Private spending accounts for 51% of total health expenditure. • In 2011, 98% of Mexican residents had some form of health coverage. Reimbursement Policies • IMSS is financed by contributions from employees and employers, with additional funding from the government. • Seguro Popular is funded entirely by the government. • Approximately 47% of health spending in Mexico is private and most of it is out-of-pocket. • The public sector is supposed to purchase only those drugs included in a basic list of interchangeable, bioequivalent generics.

Public versus Private Public • There are over 1,570 public hospitals. • IMSS runs its own primary care units and state hospitals, although the quality varies considerably. • State employees have their own clinics and hospitals. Private • About 5% of the population have private health insurance. • There are nearly 3,150 private hospitals. • The Mexican private sector accounts for 34% of total hospital beds. • Only 15% of private hospitals have more than 15 beds. News, Developments and Notes • Language: Spanish. • Regulator: Commission for the Protection against Sanitary Risks. • The quest for universal health coverage only began a decade ago.

Mexico

83

Demographics

118,395,054 km2 1,972,550 260,469 993* 200,000** Population

Area size

Total doctors

Total hospitals

Total hospital beds

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Mexico City

7.88%

Distrito Federal

City

Population

Administrative division

Ecatepec

1.47 %

State of Mexico

City

Population

Administrative division

Guadalajara

1.39%

Jalisco

City

Population

Administrative division

Puebla

1.37 %

Puebla

City

Population

Administrative division

León

1.28%

Guanajuato

* (public sector) + ca. 3,000 private ‘hospitals’ with each less than 20 beds ** (both public and private institutes) 84

Global Healthcare Report

Mexico

85

Demographics

118,395,054 km2 1,972,550 260,469 993* 200,000** Population

Area size

Total doctors

Total hospitals

Total hospital beds

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Mexico City

7.88%

Distrito Federal

City

Population

Administrative division

Ecatepec

1.47 %

State of Mexico

City

Population

Administrative division

Guadalajara

1.39%

Jalisco

City

Population

Administrative division

Puebla

1.37 %

Puebla

City

Population

Administrative division

León

1.28%

Guanajuato

* (public sector) + ca. 3,000 private ‘hospitals’ with each less than 20 beds ** (both public and private institutes) 84

Global Healthcare Report

Mexico

85

Netherlands Healthcare System • Everyone who lives or works in the Netherlands must have individual private health insurance from one of 11 insurers. • The basic (but comprehensive) insurance package is fixed by law. • In 2011, over 85% of health spending was funded by the public sector.

Public versus Private Public • Provision is mostly delivered privately but is publicly regulated. • Almost all hospitals are not-for-profit while university hospitals are public. • Only independent pharmacists and dispensing GPs can supply prescriptiononly medicines.

Reimbursement Policies • Individuals pay a community-rated premium to the insurer, plus an incomerelated contribution (6.5%) to a Risk Equalization Fund. • Individuals also have to pay 12.5% of income (up to a certain level) to finance the Exceptional Medical Expenses Act. • 66% of total healthcare expenditure is funded through compulsory contributions and premiums. • 7.8% of healthcare expenditure goes on out-of-pocket costs. • Complimentary voluntary health insurance accounts for 4% of health spending.

Private • More than 90% of hospitals are private, not-for-profit facilities. • More than 90% of the population purchases supplementary health insurance coverage. News, Developments and Notes • Language: Dutch. • Regulator: Healthcare Inspectorate. • The Exceptional Medical Expenses Act provides coverage for long-term care, mental health care and hospitalization in mental health facilities. • GPs are paid on a per capita basis as well as a fee-per-service. • Only 4% of consultations with a GP result in a referral to secondary care.

Netherlands

87

Netherlands Healthcare System • Everyone who lives or works in the Netherlands must have individual private health insurance from one of 11 insurers. • The basic (but comprehensive) insurance package is fixed by law. • In 2011, over 85% of health spending was funded by the public sector.

Public versus Private Public • Provision is mostly delivered privately but is publicly regulated. • Almost all hospitals are not-for-profit while university hospitals are public. • Only independent pharmacists and dispensing GPs can supply prescriptiononly medicines.

Reimbursement Policies • Individuals pay a community-rated premium to the insurer, plus an incomerelated contribution (6.5%) to a Risk Equalization Fund. • Individuals also have to pay 12.5% of income (up to a certain level) to finance the Exceptional Medical Expenses Act. • 66% of total healthcare expenditure is funded through compulsory contributions and premiums. • 7.8% of healthcare expenditure goes on out-of-pocket costs. • Complimentary voluntary health insurance accounts for 4% of health spending.

Private • More than 90% of hospitals are private, not-for-profit facilities. • More than 90% of the population purchases supplementary health insurance coverage. News, Developments and Notes • Language: Dutch. • Regulator: Healthcare Inspectorate. • The Exceptional Medical Expenses Act provides coverage for long-term care, mental health care and hospitalization in mental health facilities. • GPs are paid on a per capita basis as well as a fee-per-service. • Only 4% of consultations with a GP result in a referral to secondary care.

Netherlands

87

Demographics

16,819,595 km2 41,543 49,242 129 79,052 Population

Area size

Total doctors

Total hospitals

Total hospital beds

88

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Amsterdam

4.80%

Noord-Holland

City

Population

Administrative division

Rotterdam

3.66%

Zuid-Holland

City

Population

Administrative division

The Hague

3.02%

Zuid-Holland

City

Population

Administrative division

Utrecht

1.94%

Utrecht

City

Population

Administrative division

Eindhoven

1.31%

Noord-Brabant

Netherlands

89

Demographics

16,819,595 km2 41,543 49,242 129 79,052 Population

Area size

Total doctors

Total hospitals

Total hospital beds

88

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Amsterdam

4.80%

Noord-Holland

City

Population

Administrative division

Rotterdam

3.66%

Zuid-Holland

City

Population

Administrative division

The Hague

3.02%

Zuid-Holland

City

Population

Administrative division

Utrecht

1.94%

Utrecht

City

Population

Administrative division

Eindhoven

1.31%

Noord-Brabant

Netherlands

89

Norway Healthcare System • The Norwegian healthcare system is founded on the principle of universal access. • Everyone must be insured under the National Insurance Scheme (NIS). • NIS has both public and private medical services and facilities. • The responsibility for specialist care lies with the state (administered by four regional health authorities), while the municipalities are responsible for primary care. • Public sources account for over 85% of total health expenditure. Reimbursement Policies • The system is funded by taxation and via the NIS, which accounts for around 12% of total health expenditure. • Private sources (mainly in the form of out-of-pocket payments) account for approximately 15% of health expenditure. • Contributions payable by employees are calculated on gross salary and pension income. In 2011, the contribution rates were 7.8%. • NIS rates paid by employers vary regionally and range from 0% to 14%. • There are four reimbursement categories for drugs ranging between 62% – 100%.

Public versus Private Public • In 2012, there were 21 public hospital trusts, with over 100 hospital facilities. Private • 5% of the population has private health insurance. • Less than 2% of hospital beds are in private-for-profit hospitals. • GP and specialist visits, including outpatient hospital care and sameday surgery, require co-payments of NOK140 and NOK315 respectively. News, Developments and Notes • Language: Norwegian. • Regulator: Norwegian Medicines Agency. • In July 2012, the national reporting system for adverse events in hospitals was replaced by the non-punitive, electronic Reporting and Learning System.

Norway

91

Norway Healthcare System • The Norwegian healthcare system is founded on the principle of universal access. • Everyone must be insured under the National Insurance Scheme (NIS). • NIS has both public and private medical services and facilities. • The responsibility for specialist care lies with the state (administered by four regional health authorities), while the municipalities are responsible for primary care. • Public sources account for over 85% of total health expenditure. Reimbursement Policies • The system is funded by taxation and via the NIS, which accounts for around 12% of total health expenditure. • Private sources (mainly in the form of out-of-pocket payments) account for approximately 15% of health expenditure. • Contributions payable by employees are calculated on gross salary and pension income. In 2011, the contribution rates were 7.8%. • NIS rates paid by employers vary regionally and range from 0% to 14%. • There are four reimbursement categories for drugs ranging between 62% – 100%.

Public versus Private Public • In 2012, there were 21 public hospital trusts, with over 100 hospital facilities. Private • 5% of the population has private health insurance. • Less than 2% of hospital beds are in private-for-profit hospitals. • GP and specialist visits, including outpatient hospital care and sameday surgery, require co-payments of NOK140 and NOK315 respectively. News, Developments and Notes • Language: Norwegian. • Regulator: Norwegian Medicines Agency. • In July 2012, the national reporting system for adverse events in hospitals was replaced by the non-punitive, electronic Reporting and Learning System.

Norway

91

Demographics

5,096,300 km2 385,178 18,414 74 168,178 Population

Area size

Total doctors

Total hospitals

Total hospital beds

92

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Oslo

18.67 %

Oslo/Akershus

City

Population

Administrative division

Bergen

4.82%

Hordaland

City

Population

Administrative division

Stavanger/ Sandnes

3.88%

Rogaland

City

Population

Administrative division

Trondheim

3.53%

Sør-Trøndelag

City

Population

Administrative division

Kristiansand

3.05%

Vest-Agder

Norway

93

Demographics

5,096,300 km2 385,178 18,414 74 168,178 Population

Area size

Total doctors

Total hospitals

Total hospital beds

92

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Oslo

18.67 %

Oslo/Akershus

City

Population

Administrative division

Bergen

4.82%

Hordaland

City

Population

Administrative division

Stavanger/ Sandnes

3.88%

Rogaland

City

Population

Administrative division

Trondheim

3.53%

Sør-Trøndelag

City

Population

Administrative division

Kristiansand

3.05%

Vest-Agder

Norway

93

Poland Healthcare System • Healthcare in Poland is delivered through a publicly funded healthcare system. • Health insurance is mandatory, with no legal opt-out. • Managed by the National Health Fund (NFZ), which is the sole payer in the system. • Public health insurance covers 98.1% of the population. • In 2011, 70% of total health spending was funded through the public sector. Reimbursement Policies • Financed by revenues from contributions collected by the NFZ and by government budgets (state, regional or local authorities). • The NFZ contributions are calculated on gross income. It currently stands at 9% of the base – 7.75% of which is subtracted from personal income tax and 1.25% is paid directly by the individual. • Over 22% of total expenditure on health was due to out-of-pocket payments in 2008. • Depending on the type, drugs are either free, charged at a flat fee or are charged at 30% or 50% of the price.

Public versus Private Public • There are over 750 general hospitals accounting for 90% of beds. • In 2011, the Therapeutic Activity Law came into force to set about transforming public hospitals (and other public healthcare providers) into commercial code companies, in effect privatizing them. Private • The number of private hospitals has been rising in the past decade and now stands at over 225. • Voluntary health insurance is not widespread and is largely limited to medical subscription packages offered by employers. News, Developments and Notes • Language: Polish • Regulator: Office for Registration of Medicinal Products, Medical Devices and Biocidal Products and Main Pharmaceutical Inspectorate. • Poland has a problem with double (or multiple) employment among physicians. They often hold part-time salaried job in public healthcare units and work as individual medical practitioners at the same time. • Pharmacies are obliged to dispense generic equivalents. • The NFZ is prohibited from engaging in profit-making activities and cannot (directly or indirectly) operate, own or co-own healthcare institutions.

Poland

95

Poland Healthcare System • Healthcare in Poland is delivered through a publicly funded healthcare system. • Health insurance is mandatory, with no legal opt-out. • Managed by the National Health Fund (NFZ), which is the sole payer in the system. • Public health insurance covers 98.1% of the population. • In 2011, 70% of total health spending was funded through the public sector. Reimbursement Policies • Financed by revenues from contributions collected by the NFZ and by government budgets (state, regional or local authorities). • The NFZ contributions are calculated on gross income. It currently stands at 9% of the base – 7.75% of which is subtracted from personal income tax and 1.25% is paid directly by the individual. • Over 22% of total expenditure on health was due to out-of-pocket payments in 2008. • Depending on the type, drugs are either free, charged at a flat fee or are charged at 30% or 50% of the price.

Public versus Private Public • There are over 750 general hospitals accounting for 90% of beds. • In 2011, the Therapeutic Activity Law came into force to set about transforming public hospitals (and other public healthcare providers) into commercial code companies, in effect privatizing them. Private • The number of private hospitals has been rising in the past decade and now stands at over 225. • Voluntary health insurance is not widespread and is largely limited to medical subscription packages offered by employers. News, Developments and Notes • Language: Polish • Regulator: Office for Registration of Medicinal Products, Medical Devices and Biocidal Products and Main Pharmaceutical Inspectorate. • Poland has a problem with double (or multiple) employment among physicians. They often hold part-time salaried job in public healthcare units and work as individual medical practitioners at the same time. • Pharmacies are obliged to dispense generic equivalents. • The NFZ is prohibited from engaging in profit-making activities and cannot (directly or indirectly) operate, own or co-own healthcare institutions.

Poland

95

Demographics

38,186,860 km2 312,679 78,970 782 252,033 Population

Area size

Total doctors

Total hospitals

Total hospital beds

96

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Warszawa

4.27 %

Mazowieckie

City

Population

Administrative division

Łódź

2.13%

Łódzkie

City

Population

Administrative division

Kraków

1.94%

Małopolskie

City

Population

Administrative division

Wrocław

1.67 %

Dolnośląskie

City

Population

Administrative division

Poznań

1.52%

Wielkopolskie

Poland

97

Demographics

38,186,860 km2 312,679 78,970 782 252,033 Population

Area size

Total doctors

Total hospitals

Total hospital beds

96

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Warszawa

4.27 %

Mazowieckie

City

Population

Administrative division

Łódź

2.13%

Łódzkie

City

Population

Administrative division

Kraków

1.94%

Małopolskie

City

Population

Administrative division

Wrocław

1.67 %

Dolnośląskie

City

Population

Administrative division

Poznań

1.52%

Wielkopolskie

Poland

97

Portugal Healthcare System • Portugal has a National Health System funded through taxation, which covers 100% of the population. • The system, which is compulsory, combines both state-run and privately run healthcare facilities. • All healthcare benefits are administered by the Ministry of Health. • Up to 25% of the population also has an insurance scheme linked to their profession; these individuals can access both sets of services and, therefore, have double coverage. • Just 65% of health spending was funded by public sources in 2011. Reimbursement Policies • Employers must register their employees for social security coverage; deductions for coverage are automatically taken from the salary. • Individuals pay between 40% and 100% of the cost of prescription medicine. • Funding comes from government sources (direct/indirect taxes) and social security contributions. • Out-of-pocket expenditure accounts for 23% of total health expenditure. • There are four categories of co-insurance for drugs, with patients having to pay between 10% and 95%.

Public versus Private Public • The vast majority of hospitals are public, accounting for 86% of total acute care beds. Private • 6.6% of hospital beds are owned by private not-for-profit hospitals. • 7.7% of hospital beds are owned by private for-profit hospitals. • 17% of the population has duplicate private health insurance. • Nearly 9% has complimentary private insurance to cover for cost-sharing. • About 9% holds supplementary health insurance to cover for excluded services and goods. News, Developments and Notes • Language: Portuguese. • Regulator: National Authority of Medicines and Health Products. • Non-prescription drugs are priced higher than prescription drugs.

Portugal

99

Portugal Healthcare System • Portugal has a National Health System funded through taxation, which covers 100% of the population. • The system, which is compulsory, combines both state-run and privately run healthcare facilities. • All healthcare benefits are administered by the Ministry of Health. • Up to 25% of the population also has an insurance scheme linked to their profession; these individuals can access both sets of services and, therefore, have double coverage. • Just 65% of health spending was funded by public sources in 2011. Reimbursement Policies • Employers must register their employees for social security coverage; deductions for coverage are automatically taken from the salary. • Individuals pay between 40% and 100% of the cost of prescription medicine. • Funding comes from government sources (direct/indirect taxes) and social security contributions. • Out-of-pocket expenditure accounts for 23% of total health expenditure. • There are four categories of co-insurance for drugs, with patients having to pay between 10% and 95%.

Public versus Private Public • The vast majority of hospitals are public, accounting for 86% of total acute care beds. Private • 6.6% of hospital beds are owned by private not-for-profit hospitals. • 7.7% of hospital beds are owned by private for-profit hospitals. • 17% of the population has duplicate private health insurance. • Nearly 9% has complimentary private insurance to cover for cost-sharing. • About 9% holds supplementary health insurance to cover for excluded services and goods. News, Developments and Notes • Language: Portuguese. • Regulator: National Authority of Medicines and Health Products. • Non-prescription drugs are priced higher than prescription drugs.

Portugal

99

Demographics

10,487,289 km2 92,212 39,852 215 35,657 Population

Area size

Total doctors

Total hospitals

Total hospital beds

100

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Lisboa

5.22%

Lisboa e Vale do Tejo

City

Population

Administrative division

Porto

2.67 %

Norte

City

Population

Administrative division

Vila Nova de Gaia

1.78%

Norte

City

Population

Administrative division

Amadora

1.67 %

Lisboa e Vale do Tejo

City

Population

Administrative division

Braga

1.37 %

Norte

Portugal

101

Demographics

10,487,289 km2 92,212 39,852 215 35,657 Population

Area size

Total doctors

Total hospitals

Total hospital beds

100

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Lisboa

5.22%

Lisboa e Vale do Tejo

City

Population

Administrative division

Porto

2.67 %

Norte

City

Population

Administrative division

Vila Nova de Gaia

1.78%

Norte

City

Population

Administrative division

Amadora

1.67 %

Lisboa e Vale do Tejo

City

Population

Administrative division

Braga

1.37 %

Norte

Portugal

101

Russian Federation Healthcare System • Free healthcare is provided under the compulsory Mandatory Medical Insurance Scheme. • The system runs at federal, regional and municipal administrative levels. • Each residential building is assigned to a district outpatient clinic that employs a number of district physicians, specialists and has a laboratory. • Nearly a third of the population receives primary care through work-related clinics and hospitals. • Employees of some state agencies or bodies such as the military, national rail, government and, a number of ministries, have their own free clinics. • In 2011, 60% of total health expenditure was funded by public measures.

Public Versus Private Public • There are over 6,500 hospitals and more than 12,000 outpatient facilities. • Among the OECD countries, Russia has one of the highest hospital beds per capita ratios, standing at 9.2 per 1,000 population.

Reimbursement Policies • Healthcare is financed under the federal Compulsory Medical Insurance (CMI) fund through a combination of budget allocation and payroll contributions. • Most patients have to pay for their own medicines as their insurance does not cover the cost of drugs. • 29% of total health expenditure is down to out-of-pocket payments. • Spending on outpatient medicines accounts for more than 75% of formal out-of-pocket expenditures.

News, Developments and Notes • Language: Russian. • Regulator: Roszdravnadzor. • The retired, disabled and small children can get some medicines for free within a state program known as DLO (the Additional Medicines Supply Program). • As of 2011, Russian law restricts interaction between company representatives and HCPs or pharmacists during work hours, and does not allow them to receive any remuneration.

Private • There are just over 120 private hospitals, nearly all located in cities, and some 2,400 private outpatient providers. • Private healthcare is limited to big cities such Moscow and St Petersburg, whose residents are more likely to be able to afford it. • Less than 5% of the population has voluntary health insurance.

Russian Federation

103

Russian Federation Healthcare System • Free healthcare is provided under the compulsory Mandatory Medical Insurance Scheme. • The system runs at federal, regional and municipal administrative levels. • Each residential building is assigned to a district outpatient clinic that employs a number of district physicians, specialists and has a laboratory. • Nearly a third of the population receives primary care through work-related clinics and hospitals. • Employees of some state agencies or bodies such as the military, national rail, government and, a number of ministries, have their own free clinics. • In 2011, 60% of total health expenditure was funded by public measures.

Public Versus Private Public • There are over 6,500 hospitals and more than 12,000 outpatient facilities. • Among the OECD countries, Russia has one of the highest hospital beds per capita ratios, standing at 9.2 per 1,000 population.

Reimbursement Policies • Healthcare is financed under the federal Compulsory Medical Insurance (CMI) fund through a combination of budget allocation and payroll contributions. • Most patients have to pay for their own medicines as their insurance does not cover the cost of drugs. • 29% of total health expenditure is down to out-of-pocket payments. • Spending on outpatient medicines accounts for more than 75% of formal out-of-pocket expenditures.

News, Developments and Notes • Language: Russian. • Regulator: Roszdravnadzor. • The retired, disabled and small children can get some medicines for free within a state program known as DLO (the Additional Medicines Supply Program). • As of 2011, Russian law restricts interaction between company representatives and HCPs or pharmacists during work hours, and does not allow them to receive any remuneration.

Private • There are just over 120 private hospitals, nearly all located in cities, and some 2,400 private outpatient providers. • Private healthcare is limited to big cities such Moscow and St Petersburg, whose residents are more likely to be able to afford it. • Less than 5% of the population has voluntary health insurance.

Russian Federation

103

Demographics

143,600,000 km2 17,098,242 618,772 10,000 1,392,920 Population

Area size

Total doctors

Total hospitals

Total hospital beds

104

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Moskva

8.02%

Moskva

City

Population

Administrative division

St. Petersburg 3.38%

St. Petersburg

City

Population

Administrative division

Novosibirsk

1.03%

Novosibirsk Oblast

City

Population

Administrative division

Yekaterinburg

0.94%

Sverdlovsk Oblast

City

Population

Administrative division

Nizhny Novgorod

0.87

Nizhny Novgorod Oblast

%

Russian Federation

105

Demographics

143,600,000 km2 17,098,242 618,772 10,000 1,392,920 Population

Area size

Total doctors

Total hospitals

Total hospital beds

104

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Moskva

8.02%

Moskva

City

Population

Administrative division

St. Petersburg 3.38%

St. Petersburg

City

Population

Administrative division

Novosibirsk

1.03%

Novosibirsk Oblast

City

Population

Administrative division

Yekaterinburg

0.94%

Sverdlovsk Oblast

City

Population

Administrative division

Nizhny Novgorod

0.87

Nizhny Novgorod Oblast

%

Russian Federation

105

Saudi Arabia Healthcare System • Healthcare is provided free to all Saudi citizens by the Ministry of Health. • About 70% of the population is covered by the national healthcare system. • Certain government employees are covered under a quasi-government system. • The Ministry of Health and a number of semi-public organizations operate hospitals and offer medical services for their employees. • All foreign nationals must have private medical insurance; this is normally provided by the employer and enables the use of either state-run or private hospitals. • The healthcare system is struggling to keep pace with the growing population, so the government introduced initiatives to encourage the private sector to get more involved. • 69% of total health expenditure was funded by the government. • The private sector accounts for 31% of total health expenditure. Reimbursement Policies • Out-of-pocket expenses make up 58% of private health expenditure.

Public versus Private Public • The Ministry of Health operates 244 (60%) of hospitals and is involved with an additional 39 quasi-government (9%) hospitals. • Saudi Arabia’s ratio of one hospital bed for just under 500 people is among the lowest in the world. Private • 30% of the population has private health insurance. • There are 125 private hospitals (31%). • Most neighborhoods (and many of the larger compounds) have at least one private clinic providing primary healthcare. • Even with medical insurance, some hospitals and clinics may still demand payment in advance. News, Developments and Notes • Language: Arabic. • Regulator: Saudi Food and Drug Authority. • Tranquillizers, anti-depressants and sleeping pills are banned in Saudi Arabia, except in extreme cases. • In 2011, the government announced a five-year plan to develop 121 new hospitals and upgrade 66 hospitals. • As part of its development plans, the government aims to provide private healthcare coverage for publicsector workers. • Eventually, the government wants to take a step back from funding healthcare services.

Saudi Arabia

107

Saudi Arabia Healthcare System • Healthcare is provided free to all Saudi citizens by the Ministry of Health. • About 70% of the population is covered by the national healthcare system. • Certain government employees are covered under a quasi-government system. • The Ministry of Health and a number of semi-public organizations operate hospitals and offer medical services for their employees. • All foreign nationals must have private medical insurance; this is normally provided by the employer and enables the use of either state-run or private hospitals. • The healthcare system is struggling to keep pace with the growing population, so the government introduced initiatives to encourage the private sector to get more involved. • 69% of total health expenditure was funded by the government. • The private sector accounts for 31% of total health expenditure. Reimbursement Policies • Out-of-pocket expenses make up 58% of private health expenditure.

Public versus Private Public • The Ministry of Health operates 244 (60%) of hospitals and is involved with an additional 39 quasi-government (9%) hospitals. • Saudi Arabia’s ratio of one hospital bed for just under 500 people is among the lowest in the world. Private • 30% of the population has private health insurance. • There are 125 private hospitals (31%). • Most neighborhoods (and many of the larger compounds) have at least one private clinic providing primary healthcare. • Even with medical insurance, some hospitals and clinics may still demand payment in advance. News, Developments and Notes • Language: Arabic. • Regulator: Saudi Food and Drug Authority. • Tranquillizers, anti-depressants and sleeping pills are banned in Saudi Arabia, except in extreme cases. • In 2011, the government announced a five-year plan to develop 121 new hospitals and upgrade 66 hospitals. • As part of its development plans, the government aims to provide private healthcare coverage for publicsector workers. • Eventually, the government wants to take a step back from funding healthcare services.

Saudi Arabia

107

Demographics

29,195,895 km2 2,149,690 27,415 324 64,231 Population

Area size

Total doctors

Total hospitals

Total hospital beds

108

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Riyadh

18.25 %

Al Riyadh

City

Population

Administrative division

Jeddah

11.84%

Makkah

City

Population

Administrative division

Mecca

5.74%

Makkah

City

Population

Administrative division

Medina

4.04%

Al Madinah

City

Population

Administrative division

Al-Ahsa

3.64%

Ash Sharqiya

Saudi Arabia

109

Demographics

29,195,895 km2 2,149,690 27,415 324 64,231 Population

Area size

Total doctors

Total hospitals

Total hospital beds

108

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Riyadh

18.25 %

Al Riyadh

City

Population

Administrative division

Jeddah

11.84%

Makkah

City

Population

Administrative division

Mecca

5.74%

Makkah

City

Population

Administrative division

Medina

4.04%

Al Madinah

City

Population

Administrative division

Al-Ahsa

3.64%

Ash Sharqiya

Saudi Arabia

109

Slovakia Healthcare System • Healthcare provision in Slovakia is decentralized and based on a publicprivate mix. • A compulsory social health insurance scheme covers all residents. • Public health insurance is run by three health insurance companies. One is state-owned and accounts for 69% of the market. • State bodies and self-governing regions administer the system and issue permits to healthcare providers. • 71% of total health expenditure was funded by public sources in 2011.

Public versus Private Public • Many hospitals in the public sector have been transformed from state-owned facilities to not-for-profit companies or shareholder companies. • There are 12 faculty/university hospitals, which are 100% state-owned.

Reimbursement Policies • Social health insurance contributions account for 90% of public funding and government financing amounts to 10%. • The insurance contribution equates to 14% of the gross monthly earning of employees. • Out-of-pocket expenditure accounts for 26% of health expenditure. • The Ministry of Health issues a positive list of reimbursed pharmaceuticals and medical aids each quarter. • Drugs are fully reimbursed, partially reimbursed or not covered at all. Approximately one-third of the drugs on the list are have no co-payment.

News, Developments and Notes • Language: Slovak. • Regulator: State Institute for Drug Control. • GPs need to give patients a referral card in order to see a specialist. • To get an appointment for a specific time or a preferential entry, patients have to pay fees.

Private • 90% of outpatient facilities are run by the private sector. • Out-of-pocket expenditure is almost the only source of private financing as private health insurance is virtually non-existent.

Slovakia

111

Slovakia Healthcare System • Healthcare provision in Slovakia is decentralized and based on a publicprivate mix. • A compulsory social health insurance scheme covers all residents. • Public health insurance is run by three health insurance companies. One is state-owned and accounts for 69% of the market. • State bodies and self-governing regions administer the system and issue permits to healthcare providers. • 71% of total health expenditure was funded by public sources in 2011.

Public versus Private Public • Many hospitals in the public sector have been transformed from state-owned facilities to not-for-profit companies or shareholder companies. • There are 12 faculty/university hospitals, which are 100% state-owned.

Reimbursement Policies • Social health insurance contributions account for 90% of public funding and government financing amounts to 10%. • The insurance contribution equates to 14% of the gross monthly earning of employees. • Out-of-pocket expenditure accounts for 26% of health expenditure. • The Ministry of Health issues a positive list of reimbursed pharmaceuticals and medical aids each quarter. • Drugs are fully reimbursed, partially reimbursed or not covered at all. Approximately one-third of the drugs on the list are have no co-payment.

News, Developments and Notes • Language: Slovak. • Regulator: State Institute for Drug Control. • GPs need to give patients a referral card in order to see a specialist. • To get an appointment for a specific time or a preferential entry, patients have to pay fees.

Private • 90% of outpatient facilities are run by the private sector. • Out-of-pocket expenditure is almost the only source of private financing as private health insurance is virtually non-existent.

Slovakia

111

Demographics

5,410,836 km2 49,035 16,233 111 34,629 Population

Area size

Total doctors

Total hospitals

Total hospital beds

112

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Bratislava

7.90%

Bratislava

City

Population

Administrative division

Košice

4.30%

Košice

City

Population

Administrative division

Prešov

3.05%

Prešov

City

Population

Administrative division

Nitra

3.02%

Nitra

City

Population

Administrative division

Žilina

2.91%

Žilina

Slovakia

113

Demographics

5,410,836 km2 49,035 16,233 111 34,629 Population

Area size

Total doctors

Total hospitals

Total hospital beds

112

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Bratislava

7.90%

Bratislava

City

Population

Administrative division

Košice

4.30%

Košice

City

Population

Administrative division

Prešov

3.05%

Prešov

City

Population

Administrative division

Nitra

3.02%

Nitra

City

Population

Administrative division

Žilina

2.91%

Žilina

Slovakia

113

Slovenia Healthcare System • Slovenia’s compulsory statutory health insurance system covers all permanent residents. • It is supplemented by voluntary health insurance and additional insurance for services that are not covered by the compulsory system. • The system is administered by the Health Insurance Institute of Slovenia (HIIS), a public institution, independent from the government. • Primary healthcare is provided by a mix of public healthcare centers and private healthcare professionals. • The 10 regional HIIS branches are responsible for contracting providers. • In 2011, total healthcare expenditure funded by public sources was 74%, which is above the OECD average. Reimbursement Policies • Contributions constitute the major source of financing, accounting for just over 67% of total expenditure. • Employees pay just over 6% and employers pay just over 7% in contributions. • Out-of-pocket payments represent around 12.7% of private expenditure, while voluntary health insurance payments account for 13.4%.

Public versus Private Public • The majority of the hospitals are publicly owned (26). • 75% of specialist services are provided by hospitals either as inpatient or outpatient care. Private • There are only three private hospitals. • 85% of the population has voluntary complimentary health insurance. • Voluntary health insurance is provided by one not-for-profit public insurance company. News, Developments and Notes • Language: Slovene. • Regulator: Agency for Medicinal Products and Medical Devices of the Republic of Slovenia. • Slovenia issues electronic health insurance cards. • Despite contributions to the health fund, doctors may ask for an extra fee for their services.

Slovenia

115

Slovenia Healthcare System • Slovenia’s compulsory statutory health insurance system covers all permanent residents. • It is supplemented by voluntary health insurance and additional insurance for services that are not covered by the compulsory system. • The system is administered by the Health Insurance Institute of Slovenia (HIIS), a public institution, independent from the government. • Primary healthcare is provided by a mix of public healthcare centers and private healthcare professionals. • The 10 regional HIIS branches are responsible for contracting providers. • In 2011, total healthcare expenditure funded by public sources was 74%, which is above the OECD average. Reimbursement Policies • Contributions constitute the major source of financing, accounting for just over 67% of total expenditure. • Employees pay just over 6% and employers pay just over 7% in contributions. • Out-of-pocket payments represent around 12.7% of private expenditure, while voluntary health insurance payments account for 13.4%.

Public versus Private Public • The majority of the hospitals are publicly owned (26). • 75% of specialist services are provided by hospitals either as inpatient or outpatient care. Private • There are only three private hospitals. • 85% of the population has voluntary complimentary health insurance. • Voluntary health insurance is provided by one not-for-profit public insurance company. News, Developments and Notes • Language: Slovene. • Regulator: Agency for Medicinal Products and Medical Devices of the Republic of Slovenia. • Slovenia issues electronic health insurance cards. • Despite contributions to the health fund, doctors may ask for an extra fee for their services.

Slovenia

115

Demographics

2,055,496 km2 20,273 5,225 28 9,455 Population

Area size

Total doctors

Total hospitals

Total hospital beds

116

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Ljubljana

13.6%

Central Slovenia

City

Population

Administrative division

Maribor

6.32%

Northeastern Slovenia

City

Population

Administrative division

Celje

2.72%

Central Slovenia

City

Population

Administrative division

Kranj

2.53%

Eastern Slovenia

City

Population

Administrative division

Novo Mesto

2.34%

Southeastern Slovenia

Slovenia

117

Demographics

2,055,496 km2 20,273 5,225 28 9,455 Population

Area size

Total doctors

Total hospitals

Total hospital beds

116

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Ljubljana

13.6%

Central Slovenia

City

Population

Administrative division

Maribor

6.32%

Northeastern Slovenia

City

Population

Administrative division

Celje

2.72%

Central Slovenia

City

Population

Administrative division

Kranj

2.53%

Eastern Slovenia

City

Population

Administrative division

Novo Mesto

2.34%

Southeastern Slovenia

Slovenia

117

South Africa Healthcare System • The government began to roll out a universal national health insurance scheme in 2012. Starting in just 10 pilot areas, it will take about 14 years to achieve. • Over 80% of South Africans cannot afford private medical insurance and rely on publicly funded hospitals. • In 2011, 47.7% of health spending was funded by public sources, which is much lower than the OECD average of 72.2%. Reimbursement Policies • Healthcare is financed through a combination of private and public sources: general tax, private insurance and out-of-pocket payments. • Patients treated in government hospitals are charged for treatment according to a tariff, known as the Uniform Patient Fee Schedule (UPFS). The tariff depends on the level of hospital providing the treatment, the type of healthcare professional and the income of the patient.

Public versus Private Public • 300 public hospitals charge a small fee for treatment and are often overstretched. Private • About 18% of South Africans have private health insurance. • Private medical aid schemes are available either on an individual basis or by a group scheme with contributions shared by the employer and employee. • Contributions are linked to the benefit option selected. • There are over 200 private hospitals. News, Developments and Notes • Language: South Africa has eleven official languages: Afrikaans, English, Ndebele, Northern Sotho, Sotho, Swazi, Tswana, Tsonga, Venda, Xhosa and Zulu. • Regulator: The Medicines Control Council. • While the main source for funding is taxation, eventually citizens may be required to contribute directly to the system. • The HIV Counselling and Testing (HCT) campaign was launched in April 2010 – by mid-2012, almost 20 million people had been tested and knew their status. Millions were also screened for TB.

South Africa

119

South Africa Healthcare System • The government began to roll out a universal national health insurance scheme in 2012. Starting in just 10 pilot areas, it will take about 14 years to achieve. • Over 80% of South Africans cannot afford private medical insurance and rely on publicly funded hospitals. • In 2011, 47.7% of health spending was funded by public sources, which is much lower than the OECD average of 72.2%. Reimbursement Policies • Healthcare is financed through a combination of private and public sources: general tax, private insurance and out-of-pocket payments. • Patients treated in government hospitals are charged for treatment according to a tariff, known as the Uniform Patient Fee Schedule (UPFS). The tariff depends on the level of hospital providing the treatment, the type of healthcare professional and the income of the patient.

Public versus Private Public • 300 public hospitals charge a small fee for treatment and are often overstretched. Private • About 18% of South Africans have private health insurance. • Private medical aid schemes are available either on an individual basis or by a group scheme with contributions shared by the employer and employee. • Contributions are linked to the benefit option selected. • There are over 200 private hospitals. News, Developments and Notes • Language: South Africa has eleven official languages: Afrikaans, English, Ndebele, Northern Sotho, Sotho, Swazi, Tswana, Tsonga, Venda, Xhosa and Zulu. • Regulator: The Medicines Control Council. • While the main source for funding is taxation, eventually citizens may be required to contribute directly to the system. • The HIV Counselling and Testing (HCT) campaign was launched in April 2010 – by mid-2012, almost 20 million people had been tested and knew their status. Millions were also screened for TB.

South Africa

119

Demographics

52,981,991 km2 1,221,037 40,160 612 146,681 Population

Area size

Total doctors

Total hospitals

Total hospital beds

120

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Soweto

2.46%

Gauteng

City

Population

Administrative division

Johannesburg 1.85%

Gauteng

City

Population

Administrative division

Pretoria

1.43%

Gauteng

City

Population

Administrative division

Durban

1.15%

KwaZulu-Natal

City

Population

Administrative division

Tembisa

0.90%

Gauteng

South Africa

121

Demographics

52,981,991 km2 1,221,037 40,160 612 146,681 Population

Area size

Total doctors

Total hospitals

Total hospital beds

120

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Soweto

2.46%

Gauteng

City

Population

Administrative division

Johannesburg 1.85%

Gauteng

City

Population

Administrative division

Pretoria

1.43%

Gauteng

City

Population

Administrative division

Durban

1.15%

KwaZulu-Natal

City

Population

Administrative division

Tembisa

0.90%

Gauteng

South Africa

121

South Korea Healthcare System • South Korea has a universal national healthcare insurance system (NHI). • It is run by both the Health Insurance Review and Assessment Service (HIRA) and the National Health Insurance Service (NHIS). • NHI covers over 97.5% of the population, who pay a premium and have the right to access any physician or medical institution. The remaining 2.5% of the population are covered by a Medical Aid Program. • The Long-term Care Insurance Program is a social insurance system that covers 3.8% of elderly Koreans. • In 2011, the public sector proportion of total health spending was just over 55%. Reimbursement Policies • The system is primarily funded by the contributions paid by employees and employers, but is also subsidized by government. • Fee-for-service is the main reimbursement payment system for doctors. • Korea has substantial out-of-pocket payments, which accounted for 35.2% of total health spending in 2011. • Typical co-payment amounts are 20% of inpatient hospital care, 30-50% of outpatient care and 35-40% of drug costs. • The government finances 20% of total long-term care insurance.

Public versus Private • Only 10% of hospitals are in the public sector. • Patients have to get a referral from their primary care doctor to access secondary or tertiary care. • Patients can choose their doctor or medical institution, including hospitals. Private • Approximately 90% of hospitals and hospital beds are private. • Over 63% of the population has more than one private health insurance plan. News, Developments and Notes • Language: Korean. • Regulator: Food and Drug Administration. • In 2012, the Diagnosis-Related Group program became compulsory for all medical institutions to reduce unnecessary surgical services. • The cover is comprehensive; it includes health check-ups, tests and diagnosis, treatments, surgeries, preventive care, hospitalization, nursing, rehabilitation and transportation.

South Korea

123

South Korea Healthcare System • South Korea has a universal national healthcare insurance system (NHI). • It is run by both the Health Insurance Review and Assessment Service (HIRA) and the National Health Insurance Service (NHIS). • NHI covers over 97.5% of the population, who pay a premium and have the right to access any physician or medical institution. The remaining 2.5% of the population are covered by a Medical Aid Program. • The Long-term Care Insurance Program is a social insurance system that covers 3.8% of elderly Koreans. • In 2011, the public sector proportion of total health spending was just over 55%. Reimbursement Policies • The system is primarily funded by the contributions paid by employees and employers, but is also subsidized by government. • Fee-for-service is the main reimbursement payment system for doctors. • Korea has substantial out-of-pocket payments, which accounted for 35.2% of total health spending in 2011. • Typical co-payment amounts are 20% of inpatient hospital care, 30-50% of outpatient care and 35-40% of drug costs. • The government finances 20% of total long-term care insurance.

Public versus Private • Only 10% of hospitals are in the public sector. • Patients have to get a referral from their primary care doctor to access secondary or tertiary care. • Patients can choose their doctor or medical institution, including hospitals. Private • Approximately 90% of hospitals and hospital beds are private. • Over 63% of the population has more than one private health insurance plan. News, Developments and Notes • Language: Korean. • Regulator: Food and Drug Administration. • In 2012, the Diagnosis-Related Group program became compulsory for all medical institutions to reduce unnecessary surgical services. • The cover is comprehensive; it includes health check-ups, tests and diagnosis, treatments, surgeries, preventive care, hospitalization, nursing, rehabilitation and transportation.

South Korea

123

Demographics

50,219,699 km2 100,210 101,444 1,302 517,263 Population

Area size

Total doctors

Total hospitals

Total hospital beds

124

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Seoul

20.46%

Sudogwon

City

Population

Administrative division

Busan (Pusan)

7.08%

Yeongnam

City

Population

Administrative division

Incheon

5.61%

Sudogwon

City

Population

Administrative division

Daegu (Taegu)

5.01%

Yeongnam

City

Population

Administrative division

Daejeon (Taejon)

3.03%

Hoseo

South Korea

125

Demographics

50,219,699 km2 100,210 101,444 1,302 517,263 Population

Area size

Total doctors

Total hospitals

Total hospital beds

124

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Seoul

20.46%

Sudogwon

City

Population

Administrative division

Busan (Pusan)

7.08%

Yeongnam

City

Population

Administrative division

Incheon

5.61%

Sudogwon

City

Population

Administrative division

Daegu (Taegu)

5.01%

Yeongnam

City

Population

Administrative division

Daejeon (Taejon)

3.03%

Hoseo

South Korea

125

Spain Healthcare System • The National Health Service (SNS) offers universal coverage with free access to healthcare. There is no costsharing except for pharmaceuticals. • Governance of the health system is decentralized into 17 autonomous communities. • About 73% of health spending is funded by public sources, while the remaining 27% is funded by private sources. Reimbursement Policies • The system is funded through taxation. • Out-of-pocket expenditures account for about 24% of total costs. • The co-payment of medicines is based on medical conditions, the age of an individual and type of drug. As a consequence, about 24% of the population is at least partially exempted. • Patients under the age of 65 pay 40% of retail price of prescribed drugs.

Public versus Private • The primary care network is entirely public and most of the providers are salaried professionals. • Around 40% of hospitals belong to the SNS. • 71.2% of the available beds are functionally dependent on the public sector. • Overall, 40% of total bed capacity is concentrated in big high-tech hospitals. • The public system traditionally contracts out some 15–20% of specialized care provision to private (mostly non-profitmaking) hospital providers. Private • About 18% of the population purchases private insurance policies to cover services outside the basic package and to avoid waiting lists. • 60% of hospitals are in the private sector. • 40% of private hospitals’ outlay is funded from the SNS budget. News, Developments and Notes • Language: Spanish. • Regulator: Spanish Agency for Medicines and Health Products. • Civil servants are allowed to choose between public and private healthcare systems – currently 87% of the 2.5 million civil servants use the private system. • In Catalonia, two-thirds of public hospital services are provided by private, nonprofit-making hospitals integrated in the network of public providers via long-term agreements.

Spain

127

Spain Healthcare System • The National Health Service (SNS) offers universal coverage with free access to healthcare. There is no costsharing except for pharmaceuticals. • Governance of the health system is decentralized into 17 autonomous communities. • About 73% of health spending is funded by public sources, while the remaining 27% is funded by private sources. Reimbursement Policies • The system is funded through taxation. • Out-of-pocket expenditures account for about 24% of total costs. • The co-payment of medicines is based on medical conditions, the age of an individual and type of drug. As a consequence, about 24% of the population is at least partially exempted. • Patients under the age of 65 pay 40% of retail price of prescribed drugs.

Public versus Private • The primary care network is entirely public and most of the providers are salaried professionals. • Around 40% of hospitals belong to the SNS. • 71.2% of the available beds are functionally dependent on the public sector. • Overall, 40% of total bed capacity is concentrated in big high-tech hospitals. • The public system traditionally contracts out some 15–20% of specialized care provision to private (mostly non-profitmaking) hospital providers. Private • About 18% of the population purchases private insurance policies to cover services outside the basic package and to avoid waiting lists. • 60% of hospitals are in the private sector. • 40% of private hospitals’ outlay is funded from the SNS budget. News, Developments and Notes • Language: Spanish. • Regulator: Spanish Agency for Medicines and Health Products. • Civil servants are allowed to choose between public and private healthcare systems – currently 87% of the 2.5 million civil servants use the private system. • In Catalonia, two-thirds of public hospital services are provided by private, nonprofit-making hospitals integrated in the network of public providers via long-term agreements.

Spain

127

Demographics

46,704,314 km2 505,992 184,996 738 149,454 Population

Area size

Total doctors

Total hospitals

Total hospital beds

128

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Madrid

6.92%

Comunidad de Madrid

City

Population

Administrative division

Barcelona

3.47%

Cataluña

City

Population

Administrative division

Valencia

1.71%

Valencia

City

Population

Administrative division

Sevilla

1.50%

Andalucía

City

Population

Administrative division

Zaragoza

1.46%

Aragón

Spain

129

Demographics

46,704,314 km2 505,992 184,996 738 149,454 Population

Area size

Total doctors

Total hospitals

Total hospital beds

128

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Madrid

6.92%

Comunidad de Madrid

City

Population

Administrative division

Barcelona

3.47%

Cataluña

City

Population

Administrative division

Valencia

1.71%

Valencia

City

Population

Administrative division

Sevilla

1.50%

Andalucía

City

Population

Administrative division

Zaragoza

1.46%

Aragón

Spain

129

Sweden Healthcare System • The national health service provides coverage for the entire resident population and is run by an elected regional government. • 17 county councils and four regional bodies are responsible for the funding and provision of healthcare services to their populations. • Public spending accounted for 81.6% of healthcare expenditure in 2011. • About 17% of total funding of health spending is private expenditure. Reimbursement Policies • Financed mainly through proportional taxes levied by county councils (landstings or regions) and municipalities but also through state subsidies and user charges • Most services (primary, outpatient specialist care, hospital day case and inpatient care) involve a fee at the point of use. • The fee for consulting a doctor in primary care varies between SEK100 and SEK200 (€22) across the county councils. • Individuals pay the entire cost of drugs up to SEK1, 100, after which level the subsidy gradually increases to 100%. • 93% of healthcare expenditure is made up of out-of-pocket payments and voluntary insurance.

Public versus Private Public • There are about 70 public hospitals at the county level. • Most healthcare personnel are publicly employed. • About 98% of all hospital beds are public. • 12% of healthcare is financed by county councils but carried out by private care providers. Private • There are six private hospitals. • About 4% of the population has voluntary health insurance (VHI). • Voluntary health insurance is mainly linked to occupational health services as the great majority of all private insurance is paid for by employers. • In 2010, 82% of all VHI was paid for by employers, 12% was insurance for groups of employees paid for by the employees themselves and the remaining 6% was individual private insurance. News, Developments and Notes • Language: Swedish. • Regulator: Medical Products Agency. • According to OCED figures released at the end of 2013, Sweden has the best healthcare system in the world. • There is an emphasis on nurses, with 11.1 nurses per 1,000 population in 2010, compared with an OECD average of 8.7. • In November 2013, a Government Committee Directive appointed a national coordinator, with the task to analyze how healthcare personnel resources can be better utilized.

Sweden

131

Sweden Healthcare System • The national health service provides coverage for the entire resident population and is run by an elected regional government. • 17 county councils and four regional bodies are responsible for the funding and provision of healthcare services to their populations. • Public spending accounted for 81.6% of healthcare expenditure in 2011. • About 17% of total funding of health spending is private expenditure. Reimbursement Policies • Financed mainly through proportional taxes levied by county councils (landstings or regions) and municipalities but also through state subsidies and user charges • Most services (primary, outpatient specialist care, hospital day case and inpatient care) involve a fee at the point of use. • The fee for consulting a doctor in primary care varies between SEK100 and SEK200 (€22) across the county councils. • Individuals pay the entire cost of drugs up to SEK1, 100, after which level the subsidy gradually increases to 100%. • 93% of healthcare expenditure is made up of out-of-pocket payments and voluntary insurance.

Public versus Private Public • There are about 70 public hospitals at the county level. • Most healthcare personnel are publicly employed. • About 98% of all hospital beds are public. • 12% of healthcare is financed by county councils but carried out by private care providers. Private • There are six private hospitals. • About 4% of the population has voluntary health insurance (VHI). • Voluntary health insurance is mainly linked to occupational health services as the great majority of all private insurance is paid for by employers. • In 2010, 82% of all VHI was paid for by employers, 12% was insurance for groups of employees paid for by the employees themselves and the remaining 6% was individual private insurance. News, Developments and Notes • Language: Swedish. • Regulator: Medical Products Agency. • According to OCED figures released at the end of 2013, Sweden has the best healthcare system in the world. • There is an emphasis on nurses, with 11.1 nurses per 1,000 population in 2010, compared with an OECD average of 8.7. • In November 2013, a Government Committee Directive appointed a national coordinator, with the task to analyze how healthcare personnel resources can be better utilized.

Sweden

131

Demographics

9,633,490 km2 449,964 37,262 73* 26,010 Population

Area size

Total doctors

Total hospitals

Total hospital beds

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Stockholm

14.25%

Stockholms län

City

Population

Administrative division

Göteborg

5.60%

Västra Götalands län

City

Population

Administrative division

Malmö

2.91%

Skåne län

City

Population

Administrative division

Uppsala

1.46%

Uppsala län

City

Population

Administrative division

Västerås

1.15%

Västmanland län

*excl. ca. 1,000 health centres 132

Global Healthcare Report

Sweden

133

Demographics

9,633,490 km2 449,964 37,262 73* 26,010 Population

Area size

Total doctors

Total hospitals

Total hospital beds

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Stockholm

14.25%

Stockholms län

City

Population

Administrative division

Göteborg

5.60%

Västra Götalands län

City

Population

Administrative division

Malmö

2.91%

Skåne län

City

Population

Administrative division

Uppsala

1.46%

Uppsala län

City

Population

Administrative division

Västerås

1.15%

Västmanland län

*excl. ca. 1,000 health centres 132

Global Healthcare Report

Sweden

133

Switzerland Healthcare System • Switzerland has a mandatory private social health insurance system whereby individuals have to take out the basic package. • The system is highly decentralized, leaving the 26 Swiss cantons largely responsible for the provision of healthcare and insurance companies operating on a regional basis. • The Federal Office of Public Health (FOPH) provides a list of around 90 insurance providers that are registered to provide basic health insurance. • The basic package is divided into three categories: Sickness Insurance, Maternity Insurance and Accident Insurance. • Individuals can choose different levels above the basic package; those who opt for higher deductibles pay lower flat-rate premiums. • In Switzerland, 65% of health spending was funded by public sources in 2011. Reimbursement Policies • Financed by compulsory health insurance (29%), taxes (25%), other statutory insurance schemes (8%) and private payments (38%). • Individuals pay a uniform per capita premium. • Patients have to pay a 10% co-pay up to a maximum of CHF700 per year in addition to the healthcare premium and the chosen deductible. • Individual cantons provide tax-financed, means-tested subsidies directly to those unable to afford basic package premiums. In 2009, just over 30% of the population needed this help.

Public versus Private Public • 186 public hospitals. • Hospitals operational and investment costs are co-financed by cantonal taxes (55%) and health insurance premiums (45%). • Individuals can only seek treatment in their canton of residency and may not be treated in hospitals that aren’t accredited to receive reimbursement for providing basic treatment. Private • 128 private hospitals, representing one fifth of all beds. • About 70% of the population has some kind of additional health insurance covering mainly private rooms and hospital care outside the patient’s canton. News, Developments and Notes • Language: German, French, Italian and Romansh. • Regulator: SwissMedic. • Switzerland has one of the lowest proportions of public expenditures on healthcare in Europe. Yet, it has nearly twice as many nurses compared to the OECD average. • As the only strict regulation applies to permissible deductible levels, there is substantial variation in the cost of health insurance both within and between cantons. • Dependents, such as spouses or children, must have their own insurance policy.

Switzerland

135

Switzerland Healthcare System • Switzerland has a mandatory private social health insurance system whereby individuals have to take out the basic package. • The system is highly decentralized, leaving the 26 Swiss cantons largely responsible for the provision of healthcare and insurance companies operating on a regional basis. • The Federal Office of Public Health (FOPH) provides a list of around 90 insurance providers that are registered to provide basic health insurance. • The basic package is divided into three categories: Sickness Insurance, Maternity Insurance and Accident Insurance. • Individuals can choose different levels above the basic package; those who opt for higher deductibles pay lower flat-rate premiums. • In Switzerland, 65% of health spending was funded by public sources in 2011. Reimbursement Policies • Financed by compulsory health insurance (29%), taxes (25%), other statutory insurance schemes (8%) and private payments (38%). • Individuals pay a uniform per capita premium. • Patients have to pay a 10% co-pay up to a maximum of CHF700 per year in addition to the healthcare premium and the chosen deductible. • Individual cantons provide tax-financed, means-tested subsidies directly to those unable to afford basic package premiums. In 2009, just over 30% of the population needed this help.

Public versus Private Public • 186 public hospitals. • Hospitals operational and investment costs are co-financed by cantonal taxes (55%) and health insurance premiums (45%). • Individuals can only seek treatment in their canton of residency and may not be treated in hospitals that aren’t accredited to receive reimbursement for providing basic treatment. Private • 128 private hospitals, representing one fifth of all beds. • About 70% of the population has some kind of additional health insurance covering mainly private rooms and hospital care outside the patient’s canton. News, Developments and Notes • Language: German, French, Italian and Romansh. • Regulator: SwissMedic. • Switzerland has one of the lowest proportions of public expenditures on healthcare in Europe. Yet, it has nearly twice as many nurses compared to the OECD average. • As the only strict regulation applies to permissible deductible levels, there is substantial variation in the cost of health insurance both within and between cantons. • Dependents, such as spouses or children, must have their own insurance policy.

Switzerland

135

Demographics

8,014,000 km2 41,285 32,713 297 38,440 Population

Area size

Total doctors

Total hospitals

Total hospital beds

136

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Zürich

4.57%

Zürich

City

Population

Administrative division

Genève

2.21%

Genève

City

Population

Administrative division

Basel

2.06%

Basel-Stadt

City

Population

Administrative division

Bern

1.64%

Bern

City

Population

Administrative division

Lausanne

1.61%

Vaud

Switzerland

137

Demographics

8,014,000 km2 41,285 32,713 297 38,440 Population

Area size

Total doctors

Total hospitals

Total hospital beds

136

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Zürich

4.57%

Zürich

City

Population

Administrative division

Genève

2.21%

Genève

City

Population

Administrative division

Basel

2.06%

Basel-Stadt

City

Population

Administrative division

Bern

1.64%

Bern

City

Population

Administrative division

Lausanne

1.61%

Vaud

Switzerland

137

Taiwan Healthcare System • Taiwan has compulsory social insurance payable by all residents. • The health insurance program is managed by the Bureau of National Health Insurance (BNHI) and covers 99% of the population. • In 2011, about 62% of total healthcare expenditure was funded by the public sector. Reimbursement Policies • 95% of funding is raised through premiums. • Premiums are based on monthly income and linked to five categories that are mostly classified according to occupation. • Patients also have to contribute to services in the form of co-payments. • Employers pay 60% of the premium, the employee 30% and the government 10%. • The government fully subsidizes the premiums for the poor and gives partial subsidies to veterans, the self-employed and farmers. • Co-payments for hospitalization are 10% for the first 30 days and 20% thereafter. Prescriptions are charged at 20% of the cost but capped at $6 for each prescription. However, there is a co-pay ceiling. • 38% of healthcare expenditure is on out-of-pocket costs.

Public versus Private Public • 82 out of 508 hospitals are publicly owned. • 461 out of 19,722 clinics are publicly owned. • 36.5 % of beds are in public hospitals. Private • About 85% of the hospitals and 98% of the primary care clinics are private. • 63.5 % of beds are in private hospitals. News, Developments and Notes • Language: Standard Mandarin. • Regulator: The Taiwan Food and Drug Administration. • The introduction of a paperless system using a smart card has kept administrative costs at 2.35% of the total premium. • A new diagnosis-related group reimbursement system is scheduled to be fully implemented by 2015.

Taiwan

139

Taiwan Healthcare System • Taiwan has compulsory social insurance payable by all residents. • The health insurance program is managed by the Bureau of National Health Insurance (BNHI) and covers 99% of the population. • In 2011, about 62% of total healthcare expenditure was funded by the public sector. Reimbursement Policies • 95% of funding is raised through premiums. • Premiums are based on monthly income and linked to five categories that are mostly classified according to occupation. • Patients also have to contribute to services in the form of co-payments. • Employers pay 60% of the premium, the employee 30% and the government 10%. • The government fully subsidizes the premiums for the poor and gives partial subsidies to veterans, the self-employed and farmers. • Co-payments for hospitalization are 10% for the first 30 days and 20% thereafter. Prescriptions are charged at 20% of the cost but capped at $6 for each prescription. However, there is a co-pay ceiling. • 38% of healthcare expenditure is on out-of-pocket costs.

Public versus Private Public • 82 out of 508 hospitals are publicly owned. • 461 out of 19,722 clinics are publicly owned. • 36.5 % of beds are in public hospitals. Private • About 85% of the hospitals and 98% of the primary care clinics are private. • 63.5 % of beds are in private hospitals. News, Developments and Notes • Language: Standard Mandarin. • Regulator: The Taiwan Food and Drug Administration. • The introduction of a paperless system using a smart card has kept administrative costs at 2.35% of the total premium. • A new diagnosis-related group reimbursement system is scheduled to be fully implemented by 2015.

Taiwan

139

Demographics

23,340,136 km2 36,193 40,002 610 98,962 Population

Area size

Total doctors

Total hospitals

Total hospital beds

140

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Taipei

11.24%

Taipei

City

Population

Administrative division

Kaohsiung

6.61%

Kaohsiung

City

Population

Administrative division

Taichung

4.63%

Taichung

City

Population

Administrative division

Tainan

3.33%

Tainan

City

Population

Administrative division

Banqiao

2.38%

Taipei

Taiwan

141

Demographics

23,340,136 km2 36,193 40,002 610 98,962 Population

Area size

Total doctors

Total hospitals

Total hospital beds

140

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Taipei

11.24%

Taipei

City

Population

Administrative division

Kaohsiung

6.61%

Kaohsiung

City

Population

Administrative division

Taichung

4.63%

Taichung

City

Population

Administrative division

Tainan

3.33%

Tainan

City

Population

Administrative division

Banqiao

2.38%

Taipei

Taiwan

141

Turkey Healthcare System • General Health Insurance (GSS), a mandatory universal healthcare scheme, was launched in 2012. • All Turkish citizens must register with the Social Security Administration and begin paying health premiums. • Foreigners who have been resident for more than a year must now register and sign up for the universal healthcare plan. • Healthcare reform legislation has had a major impact on the organization of healthcare services. Reimbursement Policies • Employees make social security contributions out of their monthly salary. • Depending on a number of factors, including employment status, the premium can be up to 12.5%, with 5% paid by the employee and 7.5% by the employer.

Public versus Private Public • Since 2010, doctors employed in Ministry of Health and university hospitals are required to work full-time and not engage in parallel private practice. • To expand the hospital sector and use the country’s available capacity effectively, contracts with private hospitals were set up. In 2010, 421 units had agreed to provide general diagnostic and curative hospital services, with co-payments by users. Private • In 2010, private hospitals made up 34% of the total number of hospitals but only comprised 14% of total beds. News, Developments and Notes • Language: Turkish. • Regulator: General Directorate of Medicines and Pharmaceutics. • Turkey passed regulations to make private investment in its healthcare sector easier. Under the new law on public-private partnerships, the state will rent city hospitals built and run by the private sector for 25 years. • At least three hospitals are currently under construction under a PPP framework, while a dozen more are either at the contract or final bids stage. The projects are expected to add 28,000 beds to Turkey’s existing 200,000-bed capacity.

Turkey

143

Turkey Healthcare System • General Health Insurance (GSS), a mandatory universal healthcare scheme, was launched in 2012. • All Turkish citizens must register with the Social Security Administration and begin paying health premiums. • Foreigners who have been resident for more than a year must now register and sign up for the universal healthcare plan. • Healthcare reform legislation has had a major impact on the organization of healthcare services. Reimbursement Policies • Employees make social security contributions out of their monthly salary. • Depending on a number of factors, including employment status, the premium can be up to 12.5%, with 5% paid by the employee and 7.5% by the employer.

Public versus Private Public • Since 2010, doctors employed in Ministry of Health and university hospitals are required to work full-time and not engage in parallel private practice. • To expand the hospital sector and use the country’s available capacity effectively, contracts with private hospitals were set up. In 2010, 421 units had agreed to provide general diagnostic and curative hospital services, with co-payments by users. Private • In 2010, private hospitals made up 34% of the total number of hospitals but only comprised 14% of total beds. News, Developments and Notes • Language: Turkish. • Regulator: General Directorate of Medicines and Pharmaceutics. • Turkey passed regulations to make private investment in its healthcare sector easier. Under the new law on public-private partnerships, the state will rent city hospitals built and run by the private sector for 25 years. • At least three hospitals are currently under construction under a PPP framework, while a dozen more are either at the contract or final bids stage. The projects are expected to add 28,000 beds to Turkey’s existing 200,000-bed capacity.

Turkey

143

Demographics

75,627,384 km2 783,562 129,398 1,184 189,068 Population

Area size

Total doctors

Total hospitals

Total hospital beds

144

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Istanbul

15.16%

Istanbul

City

Population

Administrative division

Ankara

5.51%

Ankara

City

Population

Administrative division

Izmir

4.13%

Izmir

City

Population

Administrative division

Bursa

2.34%

Bursa

City

Population

Administrative division

Adana

2.14%

Adana

Turkey

145

Demographics

75,627,384 km2 783,562 129,398 1,184 189,068 Population

Area size

Total doctors

Total hospitals

Total hospital beds

144

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

Istanbul

15.16%

Istanbul

City

Population

Administrative division

Ankara

5.51%

Ankara

City

Population

Administrative division

Izmir

4.13%

Izmir

City

Population

Administrative division

Bursa

2.34%

Bursa

City

Population

Administrative division

Adana

2.14%

Adana

Turkey

145

UK Healthcare System • There are national health services in England, Scotland, Wales and Northern Ireland, which are publicly funded systems and cover 100% of the population. • The four are entirely independent and operate under different management, rules and political authority. • In England, 211 Clinical Commissioning Groups are responsible for commissioning secondary and community care services for the local population. • NHS England oversees the budget, planning, delivery and day-today operations of the NHS and is also responsible for specialized commissioning. • In the UK as a whole, nearly 83% of health spending was funded by public sources in 2011 while private expenditure accounted for 17%. Reimbursement policies • Each national health service is mainly funded through taxation. • A smaller amount comes from national insurance contributions, with employees paying 11% and employers 12.8%. • Prescription fees are charged, although children, those over 60, the unemployed, pregnant women and people with a chronic medical condition such as hypothyroidism are exempt.

Public versus Private Public • In general, a person must be registered with a practice in order to get treatment from a GP. • All GP practices belong now to a CCG and the groups also include other health professionals, such as nurses. • NHS hospitals also offer private services in the form of NHS pay-beds and amenity-beds. Private • About 12% of the population has supplementary private medical insurance. • A number of public hospitals are now being run by private companies as public-private partnerships, known as private finance initiatives. News, Developments and Notes • Language: English. • Regulator: Medicines and Healthcare Products Regulatory Agency. • Around 60% of prescribed items cost less than the prescription charge.

UK

147

UK Healthcare System • There are national health services in England, Scotland, Wales and Northern Ireland, which are publicly funded systems and cover 100% of the population. • The four are entirely independent and operate under different management, rules and political authority. • In England, 211 Clinical Commissioning Groups are responsible for commissioning secondary and community care services for the local population. • NHS England oversees the budget, planning, delivery and day-today operations of the NHS and is also responsible for specialized commissioning. • In the UK as a whole, nearly 83% of health spending was funded by public sources in 2011 while private expenditure accounted for 17%. Reimbursement policies • Each national health service is mainly funded through taxation. • A smaller amount comes from national insurance contributions, with employees paying 11% and employers 12.8%. • Prescription fees are charged, although children, those over 60, the unemployed, pregnant women and people with a chronic medical condition such as hypothyroidism are exempt.

Public versus Private Public • In general, a person must be registered with a practice in order to get treatment from a GP. • All GP practices belong now to a CCG and the groups also include other health professionals, such as nurses. • NHS hospitals also offer private services in the form of NHS pay-beds and amenity-beds. Private • About 12% of the population has supplementary private medical insurance. • A number of public hospitals are now being run by private companies as public-private partnerships, known as private finance initiatives. News, Developments and Notes • Language: English. • Regulator: Medicines and Healthcare Products Regulatory Agency. • Around 60% of prescribed items cost less than the prescription charge.

UK

147

Demographics

63,181,775 km2 243,610 174,698 * 189,545 Population

Area size

Total doctors

Total hospitals

Total hospital beds

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

London

11.40%

England

City

Population

Administrative division

Birmingham

1.57%

England

City

Population

Administrative division

Leeds

1.14%

England

City

Population

Administrative division

Glasgow

0.88%

Scotland

City

Population

Administrative division

Sheffield

0.81%

England

* no official data available 148

Global Healthcare Report

UK

149

Demographics

63,181,775 km2 243,610 174,698 * 189,545 Population

Area size

Total doctors

Total hospitals

Total hospital beds

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

London

11.40%

England

City

Population

Administrative division

Birmingham

1.57%

England

City

Population

Administrative division

Leeds

1.14%

England

City

Population

Administrative division

Glasgow

0.88%

Scotland

City

Population

Administrative division

Sheffield

0.81%

England

* no official data available 148

Global Healthcare Report

UK

149

USA Healthcare System • The US relies on a pay-as-you-go system. • About 84% of the population has some form of coverage, including some duplication. • 51% are covered under their employer’s insurance plans and 6% take out their own insurance. • 12% of the population is covered by Medicaid (for the poor). • 15% is covered under Medicare (for the elderly). • 1% has insurance from the Veterans Administration (VA). • About 16% of the population is uninsured and the law only guarantees these people care in emergency departments. • Among those who were insured, 30 million were underinsured in 2012, leaving them vulnerable to high out-of-pocket expenses. • The US has more than 1,300 health plans serving some 200 million people. Reimbursement Policies • Taxes finance about 46% of healthcare related to Medicaid, Medicare and the VA. • Employers purchasing cover for their current and retired employees, as well as their employees’ dependents, account for some 26% of total expenditure. • About 32% of healthcare spending is by individuals, including their portion of employer-sponsored premiums as well as out-of-pocket expenditure, which itself accounts for 13%. • Most hospitals (for-profit, not-for-profit and public) and physicians are reimbursed on a diagnosis-related group (DRG), capitation, or fee-for-service basis by private health plans or the government. • As of 2012, 31% of privately insured under65s, had a deductible of $1,200 or more.

Public vs. Private Public • Hospitals are primarily community-based, not-for-profit institutions. Governmentowned hospitals are usually operated by counties and states. • 21% of hospital beds are in the public sector and 5% are in federal institutions. Private • 60% of hospital beds are in the private, not-for-profit sector and 14% of hospital beds are in profit-making hospitals. News, Developments and Notes • Language: English. • Regulator: Food and Drug Administration. • The Affordable Care Act makes it mandatory for all individuals to carry minimum health insurance or face a yearly tax that represents a small percentage of annual income. • Health spending accounted for over 17% of GDP in 2011, by far the highest share in the OECD. • One-third of all doctors are primary care physicians. • The US allows direct-to-consumer advertising of prescription-only drugs.

USA

151

USA Healthcare System • The US relies on a pay-as-you-go system. • About 84% of the population has some form of coverage, including some duplication. • 51% are covered under their employer’s insurance plans and 6% take out their own insurance. • 12% of the population is covered by Medicaid (for the poor). • 15% is covered under Medicare (for the elderly). • 1% has insurance from the Veterans Administration (VA). • About 16% of the population is uninsured and the law only guarantees these people care in emergency departments. • Among those who were insured, 30 million were underinsured in 2012, leaving them vulnerable to high out-of-pocket expenses. • The US has more than 1,300 health plans serving some 200 million people. Reimbursement Policies • Taxes finance about 46% of healthcare related to Medicaid, Medicare and the VA. • Employers purchasing cover for their current and retired employees, as well as their employees’ dependents, account for some 26% of total expenditure. • About 32% of healthcare spending is by individuals, including their portion of employer-sponsored premiums as well as out-of-pocket expenditure, which itself accounts for 13%. • Most hospitals (for-profit, not-for-profit and public) and physicians are reimbursed on a diagnosis-related group (DRG), capitation, or fee-for-service basis by private health plans or the government. • As of 2012, 31% of privately insured under65s, had a deductible of $1,200 or more.

Public vs. Private Public • Hospitals are primarily community-based, not-for-profit institutions. Governmentowned hospitals are usually operated by counties and states. • 21% of hospital beds are in the public sector and 5% are in federal institutions. Private • 60% of hospital beds are in the private, not-for-profit sector and 14% of hospital beds are in profit-making hospitals. News, Developments and Notes • Language: English. • Regulator: Food and Drug Administration. • The Affordable Care Act makes it mandatory for all individuals to carry minimum health insurance or face a yearly tax that represents a small percentage of annual income. • Health spending accounted for over 17% of GDP in 2011, by far the highest share in the OECD. • One-third of all doctors are primary care physicians. • The US allows direct-to-consumer advertising of prescription-only drugs.

USA

151

Demographics

317,466,000 km2 9,826,675 768,268 5,794 939,699 Population

Area size

Total doctors

Total hospitals

Total hospital beds

152

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

New York City

2.62%

New York

City

Population

Administrative division

Los Angeles

1.22%

California

City

Population

Administrative division

Chicago

0.86%

Illinois

City

Population

Administrative division

Houston

0.68%

Texas

City

Population

Administrative division

Philadelphia

0.49%

Pennsylvania

USA

153

Demographics

317,466,000 km2 9,826,675 768,268 5,794 939,699 Population

Area size

Total doctors

Total hospitals

Total hospital beds

152

Global Healthcare Report

Rank

1 Rank

2 Rank

3 Rank

4 Rank

5

City

Population

Administrative division

New York City

2.62%

New York

City

Population

Administrative division

Los Angeles

1.22%

California

City

Population

Administrative division

Chicago

0.86%

Illinois

City

Population

Administrative division

Houston

0.68%

Texas

City

Population

Administrative division

Philadelphia

0.49%

Pennsylvania

USA

153

Statistics Hospital hierarchy

Statistics Hospital hierarchy

Health expenditure as % of GDP

Life expectancy at birth

USA

17.9%

Netherlands

12.0%

France

11.6%

Japan

83

Switzerland

83

Australia

82

Canada

11.2%

Canada

82

Denmark

11.2%

France

82

Germany

11.1%

Italy

82

Switzerland

10.9%

Luxembourg

82

10.6%

Spain

82

Belgium

10.6%

Sweden

82

Portugal

10.4%

Austria

Austria

82

Italy

9.5%

Finland

Ireland

9.4%

Germany

81

Spain

9.4%

Greece

81

9.4%

Sweden Japan

81

Ireland

81

9.3%

Netherlands

81

9.3%

Norway

81

Norway

9.1%

South Korea

81

Solvenia

9.1%

Belgium

80

Australia

9.0%

Portugal

80

Brazil

8.9%

Slovenia

80

Finland

8.9%

Taiwan

80

Slovakia

8.7%

UK

UK

South Africa

8.5%

Argentina

8.1%

80

Denmark

79

USA

79

7.7%

Czech Rep

7.7%

Argentina

76

China

76

Poland

76

Poland

6.7%

Saudi Arabia

76

Turkey

6.7%

Slovakia

76

Hungary Luxembourg Czech Rep

7.4%

South Korea

7.2%

Mexico

6.2%

Turkey

Russia

6.2%

Hungary

6.1%

Mexico

Taiwan China

5.2%

India

3.9%

Saudi Arabia Greece

156

3.7% 2.8%

Global Healthcare Report

78

76 75 75

Brazil

74

Russia

69

India South Africa

65 58

Statistics

157

Health expenditure as % of GDP

Life expectancy at birth

USA

17.9%

Netherlands

12.0%

France

11.6%

Japan

83

Switzerland

83

Australia

82

Canada

11.2%

Canada

82

Denmark

11.2%

France

82

Germany

11.1%

Italy

82

Switzerland

10.9%

Luxembourg

82

10.6%

Spain

82

Belgium

10.6%

Sweden

82

Portugal

10.4%

Austria

Austria

82

Italy

9.5%

Finland

Ireland

9.4%

Germany

81

Spain

9.4%

Greece

81

9.4%

Sweden Japan

81

Ireland

81

9.3%

Netherlands

81

9.3%

Norway

81

Norway

9.1%

South Korea

81

Solvenia

9.1%

Belgium

80

Australia

9.0%

Portugal

80

Brazil

8.9%

Slovenia

80

Finland

8.9%

Taiwan

80

Slovakia

8.7%

UK

UK

South Africa

8.5%

Argentina

8.1%

80

Denmark

79

USA

79

7.7%

Czech Rep

7.7%

Argentina

76

China

76

Poland

76

Poland

6.7%

Saudi Arabia

76

Turkey

6.7%

Slovakia

76

Hungary Luxembourg Czech Rep

7.4%

South Korea

7.2%

Mexico

6.2%

Turkey

Russia

6.2%

Hungary

6.1%

Mexico

Taiwan China

5.2%

India

3.9%

Saudi Arabia Greece

156

3.7% 2.8%

Global Healthcare Report

78

76 75 75

Brazil

74

Russia

69

India South Africa

65 58

Statistics

157

Physicians per 100,000 persons Nurses per 100,000 persons Pharmacists per 100,000 persons

2000

2000 1710

1600

1600 1415

1200

1251

1200

1049

959

844

797

800 400

486

385

316 48

0

800

642 378

117

40

156

68

Argentina Australia Austria

207

176

101

54

Belgium Brazil

220

1540

1138 960

879

Netherlands Norway

852

Poland

Portugal

371 146 151

340

26

China

Czech Rep

Denmark

400

110

46

Finland

600

115

France

95

Germany

94

8

0

1600

1600

Russia

330

341 88

270 58

65

100

54

Greece Hungary India Global Healthcare Report

380 106

94

Ireland Italy

214

Japan

215

Slovakia

528

Slovenia

202

126

25

South Africa

South Korea

1086

571

409

387

400 92

0

244 76

56

947

396

414

254 47

6

1100

800

630

210

1749

1200 642

300

Saudi Arabia

1220

1200

610

520

431

338

270

76

861

800

560

2000

158

72

66

1200

2000

0

46

31

Luxembourg Mexico

930

800

400

207

76

1600

1200

800

270

380

2000

1600

0

278 76

0

Canada

2000

400

400

570

540 361

291

Spain

76

Sweden

171 58

171 35

Switzerland Taiwan

277

240 35

Turkey

242 88

67

UK

USA Statistics

159

Physicians per 100,000 persons Nurses per 100,000 persons Pharmacists per 100,000 persons

2000

2000 1710

1600

1600 1415

1200

1251

1200

1049

959

844

797

800 400

486

385

316 48

0

800

642 378

117

40

156

68

Argentina Australia Austria

207

176

101

54

Belgium Brazil

220

1540

1138 960

879

Netherlands Norway

852

Poland

Portugal

371 146 151

340

26

China

Czech Rep

Denmark

400

110

46

Finland

600

115

France

95

Germany

94

8

0

1600

1600

Russia

330

341 88

270 58

65

100

54

Greece Hungary India Global Healthcare Report

380 106

94

Ireland Italy

214

Japan

215

Slovakia

528

Slovenia

202

126

25

South Africa

South Korea

1086

571

409

387

400 92

0

244 76

56

947

396

414

254 47

6

1100

800

630

210

1749

1200 642

300

Saudi Arabia

1220

1200

610

520

431

338

270

76

861

800

560

2000

158

72

66

1200

2000

0

46

31

Luxembourg Mexico

930

800

400

207

76

1600

1200

800

270

380

2000

1600

0

278 76

0

Canada

2000

400

400

570

540 361

291

Spain

76

Sweden

171 58

171 35

Switzerland Taiwan

277

240 35

Turkey

242 88

67

UK

USA Statistics

159

Hospital beds per 100,000 persons

1500

1500

1200

1200

900 600

760 450

390 230

300 0

900

650

Argentina Australia Austria

Belgium Brazil

320

Canada

1200 830

900

700 380

590

660

350

China

Czech Rep

Denmark

Finland

France

Germany

1370

Netherlands Norway

Poland

Portugal

1030

970

900

640 460

0

277

220

Russia

Saudi Arabia

Slovakia

Slovenia

South Africa

South Korea

1500 1200

1200 900

900

720

324

300

160

Luxembourg Mexico

300

1500

0

340

330 170

600

300

600

470

1500

1200

0

0

660

540

300

1500

600

600

320

600

350

Global Healthcare Report

424

270

250

300

48

Greece Hungary India

480 320

Ireland Italy

Japan

0

Spain

Sweden

Switzerland Taiwan

Turkey

300

UK

300

USA Statistics

161

Hospital beds per 100,000 persons

1500

1500

1200

1200

900 600

760 450

390 230

300 0

900

650

Argentina Australia Austria

Belgium Brazil

320

Canada

1200 830

900

700 380

590

660

350

China

Czech Rep

Denmark

Finland

France

Germany

1370

Netherlands Norway

Poland

Portugal

1030

970

900

640 460

0

277

220

Russia

Saudi Arabia

Slovakia

Slovenia

South Africa

South Korea

1500 1200

1200 900

900

720

324

300

160

Luxembourg Mexico

300

1500

0

340

330 170

600

300

600

470

1500

1200

0

0

660

540

300

1500

600

600

320

600

350

Global Healthcare Report

424

270

250

300

48

Greece Hungary India

480 320

Ireland Italy

Japan

0

Spain

Sweden

Switzerland Taiwan

Turkey

300

UK

300

USA Statistics

161

Top 10 Medical Causes of Death

Argentina Australia Austria Belgium Brazil

1

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

2

Cerebrovascular disease

Cerebrovascular disease

Cerebrovascular disease

Cerebrovascular disease

Cerebrovascular disease

3

Lower respiratory infections

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Diabetes mellitus

4

Trachea, bronchus, lung cancers

Alzheimer and other dementias

Diabetes mellitus

Lower respiratory infections

Lower respiratory infections

5

Diabetes mellitus

COPD

Hypertensive heart disease

COPD

Hypertensive heart disease

6

Colon and rectum cancers

Colon and rectum cancers

Colon and rectum cancers

Alzheimer and other dementias

COPD

7

Nephritis and nephrosis

Diabetes mellitus

COPD

Colon and rectum cancers

Trachea, bronchus, lung cancers

8

Breast cancer

Prostate cancer

Breast cancer

Breast cancer

Cirrhosis of the liver

9

Hypertensive heart disease

Breast cancer

Pancreas cancer

Prostate cancer

Inflammatory heart diseases

COPD

Lower respiratory infections

Cirrhosis of the liver

Diabetes mellitus

Stomach cancer

10

162

Global Healthcare Report

Canada

China

Czech Rep

Denmark

Finland

1

Ischaemic heart disease

Cerebrovascular disease

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

2

Trachea, bronchus, lung cancers

COPD

Cerebrovascular disease

Cerebrovascular disease

Alzheimer and other dementias

3

Cerebrovascular disease

Ischaemic heart disease

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Cerebrovascular disease

4

Alzheimer and other dementias

Trachea, bronchus, lung cancers

Colon and rectum cancers

COPD

Trachea, bronchus, lung cancer

Lower respiratory infections

Alzheimer and other dementias

Cirrhosis of the liver Colon and rectum cancers

5

COPD

Liver cancer

6

Colon and rectum cancers

Stomach cancer

COPD

Colon and rectum cancers

7

Diabetes mellitus

Oesophagus cancer

Cirrhosis of the liver

Lower respiratory infections

COPD

8

Lower respiratory infections

Hypertensive heart disease

Diabetes mellitus

Breast cancer

Pancreas cancer

9

Breast cancer

Diabetes mellitus

Hypertensive heart disease

Diabetes mellitus

Breast cancer

10

Lymphomas, multiple myeloma

Lower respiratory infections

Breast cancer

Prostate cancer

Prostate cancer

Top 10 Medical Causes of Death

163

Top 10 Medical Causes of Death

Argentina Australia Austria Belgium Brazil

1

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

2

Cerebrovascular disease

Cerebrovascular disease

Cerebrovascular disease

Cerebrovascular disease

Cerebrovascular disease

3

Lower respiratory infections

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Diabetes mellitus

4

Trachea, bronchus, lung cancers

Alzheimer and other dementias

Diabetes mellitus

Lower respiratory infections

Lower respiratory infections

5

Diabetes mellitus

COPD

Hypertensive heart disease

COPD

Hypertensive heart disease

6

Colon and rectum cancers

Colon and rectum cancers

Colon and rectum cancers

Alzheimer and other dementias

COPD

7

Nephritis and nephrosis

Diabetes mellitus

COPD

Colon and rectum cancers

Trachea, bronchus, lung cancers

8

Breast cancer

Prostate cancer

Breast cancer

Breast cancer

Cirrhosis of the liver

9

Hypertensive heart disease

Breast cancer

Pancreas cancer

Prostate cancer

Inflammatory heart diseases

COPD

Lower respiratory infections

Cirrhosis of the liver

Diabetes mellitus

Stomach cancer

10

162

Global Healthcare Report

Canada

China

Czech Rep

Denmark

Finland

1

Ischaemic heart disease

Cerebrovascular disease

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

2

Trachea, bronchus, lung cancers

COPD

Cerebrovascular disease

Cerebrovascular disease

Alzheimer and other dementias

3

Cerebrovascular disease

Ischaemic heart disease

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Cerebrovascular disease

4

Alzheimer and other dementias

Trachea, bronchus, lung cancers

Colon and rectum cancers

COPD

Trachea, bronchus, lung cancer

Lower respiratory infections

Alzheimer and other dementias

Cirrhosis of the liver Colon and rectum cancers

5

COPD

Liver cancer

6

Colon and rectum cancers

Stomach cancer

COPD

Colon and rectum cancers

7

Diabetes mellitus

Oesophagus cancer

Cirrhosis of the liver

Lower respiratory infections

COPD

8

Lower respiratory infections

Hypertensive heart disease

Diabetes mellitus

Breast cancer

Pancreas cancer

9

Breast cancer

Diabetes mellitus

Hypertensive heart disease

Diabetes mellitus

Breast cancer

10

Lymphomas, multiple myeloma

Lower respiratory infections

Breast cancer

Prostate cancer

Prostate cancer

Top 10 Medical Causes of Death

163

Top 10 Medical Causes of Death

France

Germany

Greece

Hungary

India

1

Ischaemic heart disease

Ischaemic heart disease

Cerebrovascular disease

Ischaemic heart disease

Ischaemic heart disease

2

Cerebrovascular disease

Cerebrovascular disease

Ischaemic heart disease

Cerebrovascular disease

Diarrhoeal diseases

3

Alzheimer and other dementias

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

COPD

4

Trachea, bronchus, lung cancers

Colon and rectum cancers

Upper respiratory infections

Hypertensive heart disease

5

Colon and rectum cancers

Hypertensive heart disease

Colon and rectum cancers

6

Lower respiratory infections

COPD

Breast cancer

Ireland

Italy

Japan

Luxembourg

Mexico

1

Ischaemic heart disease

Ischaemic heart disease

Cerebrovascular disease

Ischaemic heart disease

Ischaemic heart disease

2

Cerebrovascular disease

Cerebrovascular disease

Lower respiratory infections

Cerebrovascular disease

Diabetes mellitus

3

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Ischaemic heart disease

Trachea, bronchus, lung cancers

Cerebrovascular disease

Cerebrovascular disease

4

Lower respiratory infections

Hypertensive heart disease

Trachea, bronchus, lung cancers

Colon and rectum cancers

Cirrhosis of the liver

Colon and rectum cancers

Lower respiratory infections

5

COPD

COPD

Stomach cancer

COPD

Cirrhosis of the liver

Neonatal infections and conditions

6

Colon and rectum cancers

Diabetes mellitus

Colon and rectum cancers

Alzheimer and other dementias

7

Alzheimer and other dementias

Colon and rectum cancers

Liver cancer

Lower respiratory infections

8

Breast cancer

Alzheimer and other dementias

Nephritis and nephrosis

Breast cancer

9

Prostate cancer

Breast cancer

Pancreas cancer

Cirrhosis of the liver

10

Diabetes mellitus

Stomach cancer

COPD

Prostate cancer

7

Breast cancer

Diabetes mellitus

COPD

COPD

Tuberculosis

8

Diabetes mellitus

Lower respiratory infections

Nephritis and nephrosis

Diabetes mellitus

Prematurity and low birth weight

9

Prostate cancer

Breast cancer

Prostate cancer

Alzheimer and other dementias

Cirrhosis of the liver

10

Pancreas cancer

Cirrhosis of the liver

Liver cancer

Breast cancer

Birth asphyxia and birth trauma

164

Global Healthcare Report

COPD wHypertensive heart disease Lower respiratory infections Nephritis and nephrosis Congenital anomalies Endocrine disorders

Top 10 Medical Causes of Death

165

Top 10 Medical Causes of Death

France

Germany

Greece

Hungary

India

1

Ischaemic heart disease

Ischaemic heart disease

Cerebrovascular disease

Ischaemic heart disease

Ischaemic heart disease

2

Cerebrovascular disease

Cerebrovascular disease

Ischaemic heart disease

Cerebrovascular disease

Diarrhoeal diseases

3

Alzheimer and other dementias

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

COPD

4

Trachea, bronchus, lung cancers

Colon and rectum cancers

Upper respiratory infections

Hypertensive heart disease

5

Colon and rectum cancers

Hypertensive heart disease

Colon and rectum cancers

6

Lower respiratory infections

COPD

Breast cancer

Ireland

Italy

Japan

Luxembourg

Mexico

1

Ischaemic heart disease

Ischaemic heart disease

Cerebrovascular disease

Ischaemic heart disease

Ischaemic heart disease

2

Cerebrovascular disease

Cerebrovascular disease

Lower respiratory infections

Cerebrovascular disease

Diabetes mellitus

3

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Ischaemic heart disease

Trachea, bronchus, lung cancers

Cerebrovascular disease

Cerebrovascular disease

4

Lower respiratory infections

Hypertensive heart disease

Trachea, bronchus, lung cancers

Colon and rectum cancers

Cirrhosis of the liver

Colon and rectum cancers

Lower respiratory infections

5

COPD

COPD

Stomach cancer

COPD

Cirrhosis of the liver

Neonatal infections and conditions

6

Colon and rectum cancers

Diabetes mellitus

Colon and rectum cancers

Alzheimer and other dementias

7

Alzheimer and other dementias

Colon and rectum cancers

Liver cancer

Lower respiratory infections

8

Breast cancer

Alzheimer and other dementias

Nephritis and nephrosis

Breast cancer

9

Prostate cancer

Breast cancer

Pancreas cancer

Cirrhosis of the liver

10

Diabetes mellitus

Stomach cancer

COPD

Prostate cancer

7

Breast cancer

Diabetes mellitus

COPD

COPD

Tuberculosis

8

Diabetes mellitus

Lower respiratory infections

Nephritis and nephrosis

Diabetes mellitus

Prematurity and low birth weight

9

Prostate cancer

Breast cancer

Prostate cancer

Alzheimer and other dementias

Cirrhosis of the liver

10

Pancreas cancer

Cirrhosis of the liver

Liver cancer

Breast cancer

Birth asphyxia and birth trauma

164

Global Healthcare Report

COPD wHypertensive heart disease Lower respiratory infections Nephritis and nephrosis Congenital anomalies Endocrine disorders

Top 10 Medical Causes of Death

165

Top 10 Medical Causes of Death

Netherlands

Norway

Poland

Portugal

Russia

1

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

Cerebrovascular disease

Ischaemic heart disease

2

Trachea, bronchus, lung cancers

Cerebrovascular disease

Cerebrovascular disease

Ischaemic heart disease

Cerebrovascular disease

3

Cerebrovascular disease

Alzheimer and other dementias

Trachea, bronchus, lung cancers

Lower respiratory infections

Trachea, bronchus, lung cancers

4

Alzheimer and other dementias

Trachea, bronchus, lung cancers

Colon and rectum cancers

Diabetes mellitus

HIV/AIDS

Lower respiratory infections

Colon and rectum cancers

Cirrhosis of the liver Stomach cancer

5

COPD

COPD

6

Lower respiratory infections

Colon and rectum cancers

COPD

Trachea, bronchus, lung cancers

7

Colon and rectum cancers

Lower respiratory infections

Cirrhosis of the liver

Stomach cancer

Colon and rectum cancers

8

Breast cancer

Prostate cancer

Diabetes mellitus

COPD

Hypertensive heart disease

9

Diabetes mellitus

Diabetes mellitus

Stomach cancer

Nephritis and nephrosis

10

Prostate cancer

Breast cancer

Breast cancer

Prostate cancer

166

Global Healthcare Report

Tuberculosis

COPD

Saudi Arabia

Slovakia

Slovenia

South Africa

South Korea

1

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

HIV/AIDS

Cerebrovascular disease

2

Hypertensive heart disease

Cerebrovascular disease

Cerebrovascular disease

Lower respiratory infections

Ischaemic heart disease

3

Diabetes mellitus

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Diarrhoeal diseases

Trachea, bronchus, lung cancers

4

Cerebrovascular disease

Colon and rectum cancers

Colon and rectum cancers

Cerebrovascular disease

Diabetes mellitus

5

Lower respiratory infections

Lower respiratory infections

Cirrhosis of the liver

Ischaemic heart disease

Stomach cancer

6

Prematurity and low birth weight

Cirrhosis of the liver

Lower respiratory infections

Diabetes mellitus

Liver cancer

7

Congenital anomalies

Breast cancer

Inflammatory heart diseases

Tuberculosis

Colon and rectum cancers

8

Nephritis and nephrosis

Pancreas cancer

Breast cancer

Hypertensive heart disease

Cirrhosis of the liver

9

Endocrine disorders

Stomach cancer

Hypertensive heart disease

Prematurity and low birth weight

Alzheimer and other dementias

Meningitis

Lower respiratory infections

10

COPD

COPD

COPD

Top 10 Medical Causes of Death

167

Top 10 Medical Causes of Death

Netherlands

Norway

Poland

Portugal

Russia

1

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

Cerebrovascular disease

Ischaemic heart disease

2

Trachea, bronchus, lung cancers

Cerebrovascular disease

Cerebrovascular disease

Ischaemic heart disease

Cerebrovascular disease

3

Cerebrovascular disease

Alzheimer and other dementias

Trachea, bronchus, lung cancers

Lower respiratory infections

Trachea, bronchus, lung cancers

4

Alzheimer and other dementias

Trachea, bronchus, lung cancers

Colon and rectum cancers

Diabetes mellitus

HIV/AIDS

Lower respiratory infections

Colon and rectum cancers

Cirrhosis of the liver Stomach cancer

5

COPD

COPD

6

Lower respiratory infections

Colon and rectum cancers

COPD

Trachea, bronchus, lung cancers

7

Colon and rectum cancers

Lower respiratory infections

Cirrhosis of the liver

Stomach cancer

Colon and rectum cancers

8

Breast cancer

Prostate cancer

Diabetes mellitus

COPD

Hypertensive heart disease

9

Diabetes mellitus

Diabetes mellitus

Stomach cancer

Nephritis and nephrosis

10

Prostate cancer

Breast cancer

Breast cancer

Prostate cancer

166

Global Healthcare Report

Tuberculosis

COPD

Saudi Arabia

Slovakia

Slovenia

South Africa

South Korea

1

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

HIV/AIDS

Cerebrovascular disease

2

Hypertensive heart disease

Cerebrovascular disease

Cerebrovascular disease

Lower respiratory infections

Ischaemic heart disease

3

Diabetes mellitus

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Diarrhoeal diseases

Trachea, bronchus, lung cancers

4

Cerebrovascular disease

Colon and rectum cancers

Colon and rectum cancers

Cerebrovascular disease

Diabetes mellitus

5

Lower respiratory infections

Lower respiratory infections

Cirrhosis of the liver

Ischaemic heart disease

Stomach cancer

6

Prematurity and low birth weight

Cirrhosis of the liver

Lower respiratory infections

Diabetes mellitus

Liver cancer

7

Congenital anomalies

Breast cancer

Inflammatory heart diseases

Tuberculosis

Colon and rectum cancers

8

Nephritis and nephrosis

Pancreas cancer

Breast cancer

Hypertensive heart disease

Cirrhosis of the liver

9

Endocrine disorders

Stomach cancer

Hypertensive heart disease

Prematurity and low birth weight

Alzheimer and other dementias

Meningitis

Lower respiratory infections

10

COPD

COPD

COPD

Top 10 Medical Causes of Death

167

Top 10 Medical Causes of Death

Spain

Sweden

Switzerland

Taiwan

Turkey

1

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

Cerebrovascular disease

Ischaemic heart disease

2

Cerebrovascular disease

Cerebrovascular disease

Alzheimer and other dementias

COPD

Cerebrovascular disease

3

Alzheimer and other dementias

Alzheimer and other dementias

Cerebrovascular disease

Ischaemic heart disease

COPD

4

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

5

Colon and rectum cancers

Colon and rectum cancers

Hypertensive heart disease

Liver cancer

6

COPD

Prostate cancer

Colon and rectum cancers

7

Lower respiratory infections

COPD

8

Diabetes mellitus

UK

USA

1

Ischaemic heart disease

Ischaemic heart disease

2

Cerebrovascular disease

Alzheimer and other dementias

3

Lower respiratory infections

Trachea, bronchus, lung cancers

4

Trachea, bronchus, lung cancers

Cerebrovascular disease

Lower respiratory infections

5

Alzheimer and other dementias

COPD

Stomach cancer

Hypertensive heart disease

6

COPD

Diabetes mellitus

COPD

Oesophagus cancer

Prematurity and low birth weight

7

Colon and rectum cancers

Colon and rectum cancers

Lower respiratory infections

Lower respiratory infections

Hypertensive heart disease

Diabetes mellitus

8

Breast cancer

Hypertensive heart disease

9

Hypertensive heart disease

Diabetes mellitus

Diabetes mellitus

Diabetes mellitus

Stomach cancer

9

Prostate cancer

Lower respiratory infections

10

Nephritis and nephrosis

Breast cancer

Prostate cancer

Lower respiratory infections

Inflammatory heart diseases

10

Oesophagus cancer

Nephritis and nephrosis

168

Global Healthcare Report

Top 10 Medical Causes of Death

169

Top 10 Medical Causes of Death

Spain

Sweden

Switzerland

Taiwan

Turkey

1

Ischaemic heart disease

Ischaemic heart disease

Ischaemic heart disease

Cerebrovascular disease

Ischaemic heart disease

2

Cerebrovascular disease

Cerebrovascular disease

Alzheimer and other dementias

COPD

Cerebrovascular disease

3

Alzheimer and other dementias

Alzheimer and other dementias

Cerebrovascular disease

Ischaemic heart disease

COPD

4

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

Trachea, bronchus, lung cancers

5

Colon and rectum cancers

Colon and rectum cancers

Hypertensive heart disease

Liver cancer

6

COPD

Prostate cancer

Colon and rectum cancers

7

Lower respiratory infections

COPD

8

Diabetes mellitus

UK

USA

1

Ischaemic heart disease

Ischaemic heart disease

2

Cerebrovascular disease

Alzheimer and other dementias

3

Lower respiratory infections

Trachea, bronchus, lung cancers

4

Trachea, bronchus, lung cancers

Cerebrovascular disease

Lower respiratory infections

5

Alzheimer and other dementias

COPD

Stomach cancer

Hypertensive heart disease

6

COPD

Diabetes mellitus

COPD

Oesophagus cancer

Prematurity and low birth weight

7

Colon and rectum cancers

Colon and rectum cancers

Lower respiratory infections

Lower respiratory infections

Hypertensive heart disease

Diabetes mellitus

8

Breast cancer

Hypertensive heart disease

9

Hypertensive heart disease

Diabetes mellitus

Diabetes mellitus

Diabetes mellitus

Stomach cancer

9

Prostate cancer

Lower respiratory infections

10

Nephritis and nephrosis

Breast cancer

Prostate cancer

Lower respiratory infections

Inflammatory heart diseases

10

Oesophagus cancer

Nephritis and nephrosis

168

Global Healthcare Report

Top 10 Medical Causes of Death

169

Hospital hierarchy

Argentina Jefe de Servicio Jefe de Sección Medico Adjunto Medico Residente Australia Consultant Specialist registrar Registrar Senior house officer Staff grade Austria Primar Oberarzt Assistenzarzt Belgium Chef de Service Chef de Clinique Medecin or Docteur Brazil Medico Chefe Medico Medico Residente Canada Consultant Specialist registrar Registrar Senior house officer Staff grade

170

Global Healthcare Report

Czech Republic Primár Doktor Denmark Overlaege Laege Turnus laege Finland Ylilääkäri Lääkäri France Chef de Service Practicien Hospitalier Chef de Clinique Interne Germany Leitender Chefarzt Oberarzt Assistenzarzt Arzt im Praktikum Greece Diefentis Epimelitis A Epimelitis B Hungary Igazgato Föorvos Ügyeletes Föorvos

Ireland Consultant Special Registrar Registrar Senior House Officer Intern

Netherlands Afdelingshoofd Chef Arts Hoofdarts/Stafarts Dienstdocende Arts AIO

Italy Direttore del Dipartimento Responsabile Dipartimento Primario Ospedaliero Dirigente Medici di Primo Livello Medico Specializzando

Norway Sjefsoverlege Avdelingsoverlege Seksjonsoverlege Postansvarlig lege Assisterende overlege Lege

Japan Principal Head of department Head of sub-department Chief of the department Staff member

Poland Ordynator/Konsultant Doktor

Luxembourg Chef de Service Chef de Clinique Medecin or Docteur Mexico Médico jefe de area Médicos especialistas Médicos residents Médicos practicantes

Portugal Doutor Principal Doutor or Medico Russia Chief Medical Officer Chief of Department Chief Ordinator and other physicians Interns Slovakia Head Physician Deputy Head Physician House Officer Specialist Resident Head Nurse Nurse

Slovenia Medical director Head of Division Attending Physicians South Africa Consultant Senior Registrar Junior Registrar Medical Officer Intern Spain Jefe de Servicio Jefe de Sección Medico Adjunto Medico Residente

UK Consultant Specialist registrar Registrar Senior house officer Staff grade USA Medical Director Chief of division Attending physician Fellow Chief Resident Resident Intern

Sweden Chefsöverläkare Överläkare Underläkare AT-läkare Switzerland Leitender Chefarzt Oberarzt Assistenzarzt Arzt im Praktikum Turkey Director Division Chief Assistant Chief Specialist Resident

Hospital hierarchy

171

Hospital hierarchy

Argentina Jefe de Servicio Jefe de Sección Medico Adjunto Medico Residente Australia Consultant Specialist registrar Registrar Senior house officer Staff grade Austria Primar Oberarzt Assistenzarzt Belgium Chef de Service Chef de Clinique Medecin or Docteur Brazil Medico Chefe Medico Medico Residente Canada Consultant Specialist registrar Registrar Senior house officer Staff grade

170

Global Healthcare Report

Czech Republic Primár Doktor Denmark Overlaege Laege Turnus laege Finland Ylilääkäri Lääkäri France Chef de Service Practicien Hospitalier Chef de Clinique Interne Germany Leitender Chefarzt Oberarzt Assistenzarzt Arzt im Praktikum Greece Diefentis Epimelitis A Epimelitis B Hungary Igazgato Föorvos Ügyeletes Föorvos

Ireland Consultant Special Registrar Registrar Senior House Officer Intern

Netherlands Afdelingshoofd Chef Arts Hoofdarts/Stafarts Dienstdocende Arts AIO

Italy Direttore del Dipartimento Responsabile Dipartimento Primario Ospedaliero Dirigente Medici di Primo Livello Medico Specializzando

Norway Sjefsoverlege Avdelingsoverlege Seksjonsoverlege Postansvarlig lege Assisterende overlege Lege

Japan Principal Head of department Head of sub-department Chief of the department Staff member

Poland Ordynator/Konsultant Doktor

Luxembourg Chef de Service Chef de Clinique Medecin or Docteur Mexico Médico jefe de area Médicos especialistas Médicos residents Médicos practicantes

Portugal Doutor Principal Doutor or Medico Russia Chief Medical Officer Chief of Department Chief Ordinator and other physicians Interns Slovakia Head Physician Deputy Head Physician House Officer Specialist Resident Head Nurse Nurse

Slovenia Medical director Head of Division Attending Physicians South Africa Consultant Senior Registrar Junior Registrar Medical Officer Intern Spain Jefe de Servicio Jefe de Sección Medico Adjunto Medico Residente

UK Consultant Specialist registrar Registrar Senior house officer Staff grade USA Medical Director Chief of division Attending physician Fellow Chief Resident Resident Intern

Sweden Chefsöverläkare Överläkare Underläkare AT-läkare Switzerland Leitender Chefarzt Oberarzt Assistenzarzt Arzt im Praktikum Turkey Director Division Chief Assistant Chief Specialist Resident

Hospital hierarchy

171

Sources

Sources

Sources

Allianz.com Ambulance Service of NSA Angloinfo.com Argentinian National Administration of Drugs, Foods and Medical Devices Australian Department of Health: Doctor Connect Australian Health Service Alliance & Australian Centre for Health Research Report: Private Patients in Public Hospitals Australian Pharmaceutical Benefits Scheme Australian Prescriber Australian Therapeutic Goods Administration Austrian Ministry of Health bbc.co.uk Central European Labor Studies Institute Chinabusinessreview.com Civitas Colliers International Report: Kingdom of Saudi Arabia Healthcare Overview Commonwealth Fund Report: International Profiles 2013 Competition Commission Report: Review of Competition in the South African Health System Consult BRIC Guide Czech Republic Ministry of Health Czech Republic National Reference Center Czech Republic State Institute for Drug Control Danish Ministry of Health/Ministry of Foreign Affairs 174

Global Healthcare Report

Euphoric Project Report on Austria Euraxess.sk European Commission Fiches: Joint Report on Health Systems European Hospital and Healthcare Federation (HOPE) European Medicines Agency European Union of General Practitioners Europe-cites.com Exame.abril.com.br Examiner.com Finnish Ministry of Health/National Institute for Health and Welfare Gabionline.net German Federal Institute for Drugs and Medical Devices Globepharm.org Health Canada Health Policy Health Policy and Planning HealthcareonLocation.com Healthydebate.ca Hospitalbuild-me.com IMS Institute Report: Understanding Healthcare Access in India International Hospital Federation – Hospital Sector Reports: Belgium/France/Hungary/ Italy/Japan/Luxembourg International Medical Community Report: Review of the South Korean Healthcare System Irish Health Service Executive ISPOR Italian Journal of Public Health Justlanded.com

Kaiser Permanente International Report: Selected European Countries’ Health Care Systems Luxembourg.lu McKinsey & Co Medical News Today Medicover.co.za Mexican Health Foundation Report (Working Papers series): Financing in Argentina Mydr.com.au National Constitution of India NHS England Norwegian School of Economics OECD Ontario Ministry of Health Oxford Business Group Pharmaboardroom.com PMLive.com PricewaterhouseCoopers Report: Checking up on Taiwan Healthcare Reuters.com Saudi Arabian Embassy Saudi Food and Drug Authority Slovenia.si South African Medicines Control Council Southafrica.info Sweden.se Taiwanese Center for Drug Evaluation Taiwanese Government Taiwanese National Health Insurance Administration The Daily Telegraph The Economist The Economist Insights The Guardian

he Health Systems and Policy Monitor T The Hospital District of Helsinki and Uusimaa The Lancet: Health Policy series The New York Times The Times of India The World Bank Theconversation.com Trefis.com Turkish Social Security Institution Handbook University of Leuven US Dept. of Commerce, Commercial Service US FDA WHO and Australian Institute of Health and Welfare Report: Health Service Delivery WHO/European Observatory: Healthcare in Transition Reports Workingin-australia.com

Sources

175

Sources

Allianz.com Ambulance Service of NSA Angloinfo.com Argentinian National Administration of Drugs, Foods and Medical Devices Australian Department of Health: Doctor Connect Australian Health Service Alliance & Australian Centre for Health Research Report: Private Patients in Public Hospitals Australian Pharmaceutical Benefits Scheme Australian Prescriber Australian Therapeutic Goods Administration Austrian Ministry of Health bbc.co.uk Central European Labor Studies Institute Chinabusinessreview.com Civitas Colliers International Report: Kingdom of Saudi Arabia Healthcare Overview Commonwealth Fund Report: International Profiles 2013 Competition Commission Report: Review of Competition in the South African Health System Consult BRIC Guide Czech Republic Ministry of Health Czech Republic National Reference Center Czech Republic State Institute for Drug Control Danish Ministry of Health/Ministry of Foreign Affairs 174

Global Healthcare Report

Euphoric Project Report on Austria Euraxess.sk European Commission Fiches: Joint Report on Health Systems European Hospital and Healthcare Federation (HOPE) European Medicines Agency European Union of General Practitioners Europe-cites.com Exame.abril.com.br Examiner.com Finnish Ministry of Health/National Institute for Health and Welfare Gabionline.net German Federal Institute for Drugs and Medical Devices Globepharm.org Health Canada Health Policy Health Policy and Planning HealthcareonLocation.com Healthydebate.ca Hospitalbuild-me.com IMS Institute Report: Understanding Healthcare Access in India International Hospital Federation – Hospital Sector Reports: Belgium/France/Hungary/ Italy/Japan/Luxembourg International Medical Community Report: Review of the South Korean Healthcare System Irish Health Service Executive ISPOR Italian Journal of Public Health Justlanded.com

Kaiser Permanente International Report: Selected European Countries’ Health Care Systems Luxembourg.lu McKinsey & Co Medical News Today Medicover.co.za Mexican Health Foundation Report (Working Papers series): Financing in Argentina Mydr.com.au National Constitution of India NHS England Norwegian School of Economics OECD Ontario Ministry of Health Oxford Business Group Pharmaboardroom.com PMLive.com PricewaterhouseCoopers Report: Checking up on Taiwan Healthcare Reuters.com Saudi Arabian Embassy Saudi Food and Drug Authority Slovenia.si South African Medicines Control Council Southafrica.info Sweden.se Taiwanese Center for Drug Evaluation Taiwanese Government Taiwanese National Health Insurance Administration The Daily Telegraph The Economist The Economist Insights The Guardian

he Health Systems and Policy Monitor T The Hospital District of Helsinki and Uusimaa The Lancet: Health Policy series The New York Times The Times of India The World Bank Theconversation.com Trefis.com Turkish Social Security Institution Handbook University of Leuven US Dept. of Commerce, Commercial Service US FDA WHO and Australian Institute of Health and Welfare Report: Health Service Delivery WHO/European Observatory: Healthcare in Transition Reports Workingin-australia.com

Sources

175

Global Healthcare Report Public holidays Main International Conferences Workforce Counts

Workforce Counts

1

20

Global Healthcare Report

Public holidays 2014

January

Argentina

1

February March April 3–4, 24 2,18

May 1–2,25

Could be difficult to interview

Very difficult to interview

Difficult to interview

Extremely difficult to interview

June

20

Argentina 9 18 13 24 8,25–26

Australia 1,26–27 18–21,25

July

August

September

October

November December

Australia 25–26

Austria 1,6 21

1,29

9,19

Austria 15 26 1 8,25–26

Belgium 1

1,29

8-9

Belgium 21 15 27 1,11 25

19

Brazil 7 12 2,15 24–25,31

20-21

Brazil 1 4-5 18,20-21 1 Canada 1

18,21

19

Canada 1 1 13 12 25–26

China 1,31

5-7

1-3,31 1-2

China

20-21

1,8

Czech Rep 5–6 28 28 17

Czech Rep

1-6

1

6–8

1–7 24–26

Denmark 1 17-18,20-21 16,29

8-9

Denmark 25–26

Finland 1,6 18,20-21 1,29

8,21

1 6,25–26 Finland

France 1

21

1,8,29 9

1,11 25 France 14 15

Germany 1 18, 21

1,29

9

3 25–26 Germany

Greece

1

9

Greece 15 28 25–26

8-9

Hungary 20 23 1 25–26

1,6 3, 25 18,20-21

Hungary 1 15 20-21

1

India 14,26 27 16 13,18 14 Ireland 1 17 21

India 15,17 2–3,23 4,6 25

5

2

Ireland 4 27 25–26

Italy

1,6 20-21,25 1

2

Italy 15

Japan

1, 13

11

21

Luxembourg 1

29

3–6

21

1,29

Mexico 1 3,5 17,21 17-18

1 8,25–26

Japan 21 15,23 13 3,23–24 23 9,23

1

Luxembourg 15 1 25–26 Mexico 16 17,20 25

Netherlands 1

18,20-21,26-27 5,29

8-9

Netherlands 25–26

Norway 1

17-18,20-21 1,17,29 8-9

Norway 25–26

Poland

20-21

8,19

Poland 15 1,11 25–26

10

Portugal 15 8,25

1, 6

Portugal 1 Russia

1–8

1,3

18,20,25 1

22-23 8,10

1–4,9

12-15

Russia 1–4

Saudi Arabia 5

Saudi Arabia 28–31 1–3 23,30 1–10

Slovakia 1,6 18,20-21 1,8

Slovakia 5 29 1,15 1,17 24–26

Slovenia 1

8 20-21,27 1-2

South Africa 1 21 18,21,27-28

1

South Korea 1,30,31 1 5-6 Spain 1,6 18

8,25

Slovenia 15 31 1 25–26

16

South Africa 9 24 16,25–26

6

South Korea 15 7–9 3,9

1

25

12–13 1 6,8,25 Spain 15

Sweden 1,6 18,20-21 1,29

6,8,21

Sweden

Switzerland 1 18,20-21

29

8-9

Switzerland 1 21 25–26

Taiwan 1,30-31

1 25–26

2

Taiwan 8 10

1-4,28

4-5

1

Turkey 1

23

1,19

Turkey 28 30 4,29

UK 1 18

5,26

25–26 UK 27

USA 1,20 17

26

USA 4

2

Global Healthcare Report Supplement

1

11,27 25

Public Holidays

3

Public holidays 2014

January

Argentina

1

February March April 3–4, 24 2,18

May 1–2,25

Could be difficult to interview

Very difficult to interview

Difficult to interview

Extremely difficult to interview

June

20

Argentina 9 18 13 24 8,25–26

Australia 1,26–27 18–21,25

July

August

September

October

November December

Australia 25–26

Austria 1,6 21

1,29

9,19

Austria 15 26 1 8,25–26

Belgium 1

1,29

8-9

Belgium 21 15 27 1,11 25

19

Brazil 7 12 2,15 24–25,31

20-21

Brazil 1 4-5 18,20-21 1 Canada 1

18,21

19

Canada 1 1 13 12 25–26

China 1,31

5-7

1-3,31 1-2

China

20-21

1,8

Czech Rep 5–6 28 28 17

Czech Rep

1-6

1

6–8

1–7 24–26

Denmark 1 17-18,20-21 16,29

8-9

Denmark 25–26

Finland 1,6 18,20-21 1,29

8,21

1 6,25–26 Finland

France 1

21

1,8,29 9

1,11 25 France 14 15

Germany 1 18, 21

1,29

9

3 25–26 Germany

Greece

1

9

Greece 15 28 25–26

8-9

Hungary 20 23 1 25–26

1,6 3, 25 18,20-21

Hungary 1 15 20-21

1

India 14,26 27 16 13,18 14 Ireland 1 17 21

India 15,17 2–3,23 4,6 25

5

2

Ireland 4 27 25–26

Italy

1,6 20-21,25 1

2

Italy 15

Japan

1, 13

11

21

Luxembourg 1

29

3–6

21

1,29

Mexico 1 3,5 17,21 17-18

1 8,25–26

Japan 21 15,23 13 3,23–24 23 9,23

1

Luxembourg 15 1 25–26 Mexico 16 17,20 25

Netherlands 1

18,20-21,26-27 5,29

8-9

Netherlands 25–26

Norway 1

17-18,20-21 1,17,29 8-9

Norway 25–26

Poland

20-21

8,19

Poland 15 1,11 25–26

10

Portugal 15 8,25

1, 6

Portugal 1 Russia

1–8

1,3

18,20,25 1

22-23 8,10

1–4,9

12-15

Russia 1–4

Saudi Arabia 5

Saudi Arabia 28–31 1–3 23,30 1–10

Slovakia 1,6 18,20-21 1,8

Slovakia 5 29 1,15 1,17 24–26

Slovenia 1

8 20-21,27 1-2

South Africa 1 21 18,21,27-28

1

South Korea 1,30,31 1 5-6 Spain 1,6 18

8,25

Slovenia 15 31 1 25–26

16

South Africa 9 24 16,25–26

6

South Korea 15 7–9 3,9

1

25

12–13 1 6,8,25 Spain 15

Sweden 1,6 18,20-21 1,29

6,8,21

Sweden

Switzerland 1 18,20-21

29

8-9

Switzerland 1 21 25–26

Taiwan 1,30-31

1 25–26

2

Taiwan 8 10

1-4,28

4-5

1

Turkey 1

23

1,19

Turkey 28 30 4,29

UK 1 18

5,26

25–26 UK 27

USA 1,20 17

26

USA 4

2

Global Healthcare Report Supplement

1

11,27 25

Public Holidays

3

Public holidays 2015

January

Argentina 1

February March 16–17

April

May

24 2–3

1,25

Could be difficult to interview

Very difficult to interview

Difficult to interview

Extremely difficult to interview

June

20

Argentina 9 17 12 23 8,25

July

August

September

October

November December

Australia 1,26 3–6,25

Australia 25–26,28

Austria 1,6 6

1,14,25 4

Austria 15 26 1 8,25–26

Belgium 1

1,14,24–25

Belgium 21 15 1,11 25

5–6

Brazil 1 17–18 3,5,21 1

4

Brazil 7 12 2,15 24–25,31

Canada 1

3,6

18

Canada 1 7 12 25–26

China 1

5

1–3 20

China

5–6

1,8

Czech Rep 5–6 28 28 17

Czech Rep

18–20

1

27

1–3 24–26

Denmark 1 2–3,5–6 1,14,24–25

Denmark 25–26

Finland 1 3,5–6 1,14,24 20

31 6,25–26 Finland

France 1

1,8,29 9

1,11 25 France 14 15

1,14,25

3 25–26 Germany

21

Germany 1 3,6 Greece 1,6

23 25 10,12–13 1

1

Greece 15 28 25–26

Hungary 1 15 5–6 1,24–25

Hungary 20 23 23 1 25–26

India 14,26 17 6,27 2–3,15 14

India 15,17 2,22–23 4,6 25

Ireland 1 17 6 4 1

Ireland 3 26 25–26

Italy

Italy 15

1,6 5,6,25 1

Japan 1,12

11

21

Luxembourg 1

2

29

3–6

6

1,14,25

1 8,25–26

21–23 12 3,23 23 Japan 20 23

Luxembourg 15 1 25–26

Mexico 1 2,5 16,21 2–3

1

Mexico 16 16,20 25

Netherlands 1

3,5–6,27

5,14,24–25

Netherlands 25–26

Norway 1

2–3,5–6 1,14,17,24–25

Norway 25–26

Poland

5–6

4

Poland 15 1,11 25–26

10

Portugal 15 8,25

1, 6

Portugal 1 Russia

1–2,5–8

23 8–9

1,3,24

3,5,25 1 1,9,11

Russia 4

Saudi Arabia

Saudi Arabia 18–24 19–29

Slovakia 1,6

3,5–6 1,8

Slovakia 5 29 1,15 1,17 24–26

Slovenia

8

5–6, 27

1–2,24

25

Slovenia 15 31 1 25–26

South Africa 1 21

3,6, 27

1

16

South Africa 9–10 24 16,25–26

6

South Korea 15 26–28 3,9

1

South Korea 1

18–20 1 5,25

Spain 1,6 3

1

25

12 1 6,8,25 Spain 15

Sweden 1,6 3,5–6 1,14,24 6,20

Sweden 31 25–26

Switzerland 1 3,5–6

14,24,25

Switzerland 1 20 24–26,31

Taiwan 1

4–5

1

23

1,19

18–23,28

Turkey 1

20

Taiwan 27 10 Turkey 18 30 24 29

UK 1 3 4,25

25–26,28 UK

USA 1,19 16

USA 3,4 7

4

Global Healthcare Report Supplement

25

11,26 25

Public Holidays

5

Public holidays 2015

January

Argentina 1

February March 16–17

April

May

24 2–3

1,25

Could be difficult to interview

Very difficult to interview

Difficult to interview

Extremely difficult to interview

June

20

Argentina 9 17 12 23 8,25

July

August

September

October

November December

Australia 1,26 3–6,25

Australia 25–26,28

Austria 1,6 6

1,14,25 4

Austria 15 26 1 8,25–26

Belgium 1

1,14,24–25

Belgium 21 15 1,11 25

5–6

Brazil 1 17–18 3,5,21 1

4

Brazil 7 12 2,15 24–25,31

Canada 1

3,6

18

Canada 1 7 12 25–26

China 1

5

1–3 20

China

5–6

1,8

Czech Rep 5–6 28 28 17

Czech Rep

18–20

1

27

1–3 24–26

Denmark 1 2–3,5–6 1,14,24–25

Denmark 25–26

Finland 1 3,5–6 1,14,24 20

31 6,25–26 Finland

France 1

1,8,29 9

1,11 25 France 14 15

1,14,25

3 25–26 Germany

21

Germany 1 3,6 Greece 1,6

23 25 10,12–13 1

1

Greece 15 28 25–26

Hungary 1 15 5–6 1,24–25

Hungary 20 23 23 1 25–26

India 14,26 17 6,27 2–3,15 14

India 15,17 2,22–23 4,6 25

Ireland 1 17 6 4 1

Ireland 3 26 25–26

Italy

Italy 15

1,6 5,6,25 1

Japan 1,12

11

21

Luxembourg 1

2

29

3–6

6

1,14,25

1 8,25–26

21–23 12 3,23 23 Japan 20 23

Luxembourg 15 1 25–26

Mexico 1 2,5 16,21 2–3

1

Mexico 16 16,20 25

Netherlands 1

3,5–6,27

5,14,24–25

Netherlands 25–26

Norway 1

2–3,5–6 1,14,17,24–25

Norway 25–26

Poland

5–6

4

Poland 15 1,11 25–26

10

Portugal 15 8,25

1, 6

Portugal 1 Russia

1–2,5–8

23 8–9

1,3,24

3,5,25 1 1,9,11

Russia 4

Saudi Arabia

Saudi Arabia 18–24 19–29

Slovakia 1,6

3,5–6 1,8

Slovakia 5 29 1,15 1,17 24–26

Slovenia

8

5–6, 27

1–2,24

25

Slovenia 15 31 1 25–26

South Africa 1 21

3,6, 27

1

16

South Africa 9–10 24 16,25–26

6

South Korea 15 26–28 3,9

1

South Korea 1

18–20 1 5,25

Spain 1,6 3

1

25

12 1 6,8,25 Spain 15

Sweden 1,6 3,5–6 1,14,24 6,20

Sweden 31 25–26

Switzerland 1 3,5–6

14,24,25

Switzerland 1 20 24–26,31

Taiwan 1

4–5

1

23

1,19

18–23,28

Turkey 1

20

Taiwan 27 10 Turkey 18 30 24 29

UK 1 3 4,25

25–26,28 UK

USA 1,19 16

USA 3,4 7

4

Global Healthcare Report Supplement

25

11,26 25

Public Holidays

5

Main International Conferences 2014 Month Date Conference

Location

Month Date Conference

Location

May 1–4

ADI 2014 – 29th International Conference of Alzheimer’s Disease International

San Juan, Puerto Rico

19–23 42nd Annual Advances in Internal Medicine

San Francisco, United States

3–7

16th European Congress of Endocrinology (ECE 2014)

Wroclaw, Poland

4–7

7th World Congress on Pediatric Intensive and Critical Care Istanbul, Turkey

31–3 Jun 51st European Renal Association – European Dialysis and Transplant Association Congress

Amsterdam, Netherlands

Istanbul, Turkey

6–8 Africa Health

Johannesburg, South Africa

Nice, France

6–9

XXIII European Stroke Conference

7–10 HIV Drug Therapy in the Americas

Rio de Janeiro, Brazil

7–10 7th World Congress of the World Institute of Pain

Maastricht, Netherlands

7–10

Glasgow, United Kingdom

23rd European Congress of Obstetrics and Gynaecology (EBCOG)

8–10 EuroPRevent 2014 – Preventative Cardiology

Amsterdam, Netherlands

8–11

8th World Congress on Controversies in Neurology (CONy) Berlin, Germany

11–14

International Society of Cellular Oncology (ISCO) 2014

Malaga, Spain

14–15 WFH 2014 World Congress

Melbourne, Australia

23rd Biannual International Congress on Thrombosis

Valencia, Spain

16–18

3rd Regional International Gynecologic Cancer Society Meeting 2014

Cape Town, South Africa

BIT’s 7th Annual World Cancer Congress 2014

Nanjing, China

14–17

16–18

31–3 Jun Joint Congress of European Neurology (ENS/EFNS 2014)

June 5–7

8th World Research Congress of the European Association for Palliative Care

Lleida, Spain

7–11

European Academy of Allergy and Clinical Immunology Annual Congress 2014

Copenhagen, Denmark

8–12

18th International Congress of Parkinson’s Disease and Movement Disorders

Stockholm, Sweden

47th Annual Meeting of ESPGHAN

Jerusalem, Israel

12–15

19th Congress of the European Haematology Association (EHA)

Milan, Italy

24th European Meeting on Hypertension

Athens, Greece

9–12

13–16

14–18 World Association for Infant Mental Health

Edinburgh, United Kingdom

16–18 The Global Emergency Medicine Meeting 2014

Shenzhen, China

18–20

3rd World Congress on Vascular Access

Berlin, Germany

18–21

European Society of Gastrointestinal and Abdominal Radiology – ESGAR 2014

Salzburg, Austria

18–21

14th Congress of the European Association of Paediatric Surgeons (EUPSA)

Dublin, Ireland

7th World Congress of Pediatric Cardiology

Istanbul, Turkey

16–21 Annual AUA Meeting 2014

Orlando, United States

Heart Failure Congress 2014

Athens, Greece

21–24 ICE/ENDO 2014

Chicago, United States

IARS (International Anesthesia Research Society) 2014 Annual Meeting

Montreal, Canada

23–24 3rd Annual Global Healthcare Conference

Singapore, Singapore

17–20

17–20 6

Global Healthcare Report Supplement

18–23

Main International Conferences

7

Main International Conferences 2014 Month Date Conference

Location

Month Date Conference

Location

May 1–4

ADI 2014 – 29th International Conference of Alzheimer’s Disease International

San Juan, Puerto Rico

19–23 42nd Annual Advances in Internal Medicine

San Francisco, United States

3–7

16th European Congress of Endocrinology (ECE 2014)

Wroclaw, Poland

4–7

7th World Congress on Pediatric Intensive and Critical Care Istanbul, Turkey

31–3 Jun 51st European Renal Association – European Dialysis and Transplant Association Congress

Amsterdam, Netherlands

Istanbul, Turkey

6–8 Africa Health

Johannesburg, South Africa

Nice, France

6–9

XXIII European Stroke Conference

7–10 HIV Drug Therapy in the Americas

Rio de Janeiro, Brazil

7–10 7th World Congress of the World Institute of Pain

Maastricht, Netherlands

7–10

Glasgow, United Kingdom

23rd European Congress of Obstetrics and Gynaecology (EBCOG)

8–10 EuroPRevent 2014 – Preventative Cardiology

Amsterdam, Netherlands

8–11

8th World Congress on Controversies in Neurology (CONy) Berlin, Germany

11–14

International Society of Cellular Oncology (ISCO) 2014

Malaga, Spain

14–15 WFH 2014 World Congress

Melbourne, Australia

23rd Biannual International Congress on Thrombosis

Valencia, Spain

16–18

3rd Regional International Gynecologic Cancer Society Meeting 2014

Cape Town, South Africa

BIT’s 7th Annual World Cancer Congress 2014

Nanjing, China

14–17

16–18

31–3 Jun Joint Congress of European Neurology (ENS/EFNS 2014)

June 5–7

8th World Research Congress of the European Association for Palliative Care

Lleida, Spain

7–11

European Academy of Allergy and Clinical Immunology Annual Congress 2014

Copenhagen, Denmark

8–12

18th International Congress of Parkinson’s Disease and Movement Disorders

Stockholm, Sweden

47th Annual Meeting of ESPGHAN

Jerusalem, Israel

12–15

19th Congress of the European Haematology Association (EHA)

Milan, Italy

24th European Meeting on Hypertension

Athens, Greece

9–12

13–16

14–18 World Association for Infant Mental Health

Edinburgh, United Kingdom

16–18 The Global Emergency Medicine Meeting 2014

Shenzhen, China

18–20

3rd World Congress on Vascular Access

Berlin, Germany

18–21

European Society of Gastrointestinal and Abdominal Radiology – ESGAR 2014

Salzburg, Austria

18–21

14th Congress of the European Association of Paediatric Surgeons (EUPSA)

Dublin, Ireland

7th World Congress of Pediatric Cardiology

Istanbul, Turkey

16–21 Annual AUA Meeting 2014

Orlando, United States

Heart Failure Congress 2014

Athens, Greece

21–24 ICE/ENDO 2014

Chicago, United States

IARS (International Anesthesia Research Society) 2014 Annual Meeting

Montreal, Canada

23–24 3rd Annual Global Healthcare Conference

Singapore, Singapore

17–20

17–20 6

Global Healthcare Report Supplement

18–23

Main International Conferences

7

Main International Conferences 2014 Month Date Conference

Location

Month Date Conference

Location

25–28

Barcelona, Spain

16th World Congress of Psychiatry

Madrid, Spain

15–19

50th EASD Annual Meeting – the European Association for the Study of Diabetes

Tel Aviv, Israel

17–19

14th International Congress of Cardiothoracic and Vascular Anaesthesia (EACTA Annual Meeting 2014)

Florence, Italy

16th World Congress on Gastrointestinal Cancer (ESMO 2014)

26–28 International Symposium on Supportive Care in Cancer

Miami, United States

July

5–8

23rd EACR – European Association for Cancer Research

Munich, Germany

6–9

5th International Congress of Psoriasis 2014

Paris, France

12–17 Alzheimer’s Association International Conference

Copenhagen, Denmark

20–25 AIDS 2014

Melbourne, Australia

25–28

Boston, United States

International Academy of Cardiology, Annual Scientific Sessions 2014, 19th World Congress on Heart Disease

28–30 3rd International Conference on Gastroenterology & Urology San Antonio, United States August

21–23

6th Latin American Conference on Lung Cancer (LALCA)

30–3 Sep European Society of Cardiology Congress 2014

Lima, Peru Barcelona, Spain

30– 3 Sep 26th European Congress of Pathology (ECP 2014)

London, United Kingdom

September 2–4

Maastricht, Netherlands

53rd Annual Scientific Meeting of the International Spinal Cord Society

3–6 15th World Congress on Cancers of the Skin

Edinburgh, United Kingdom

4–7

World Congress on NeuroTherapeutics

Basel, Switzerland

6–10

European Respiratory Society Annual Congress

Munich, Germany

10–13

European Association for Behavioural & Cognitive Therapies Congress 2014

The Hague, Netherlands

12–14

2014 Chinese Congress and Exposition on Gerontology and Health Industry

Suzhou, China

8

Global Healthcare Report Supplement

14–18

18–21 1st Euro–Asian Melanoma Congress

Sarajevo, Bosnia And Herzegovina

22–25

Stockholm, Sweden

European Society for Vascular Surgery – 28th Annual Meeting

24–27 Southern African HIV Clinicians Society Conference 2014

Cape Town, South Africa

25–27

International Conference on Repair, Regeneration and Reconstruction

London, United Kingdom

26–30 27–1 Oct

39th ESMO Congress – the European Society for Medical Oncology

Madrid, Spain

LIVES 2014 – the European Society of Intensive Care Medicine (ESICM) Congress

Barcelona, Spain

October

Eurospine 2014

Lyon, France

1–3

5–8 Heart Rhythm Congress 2014

Birmingham, United Kingdom

9–11

Atlanta, United States

28th Annual North American Cystic Fibrosis (NACF) Conference

9–11 The Viral Hepatitis Congress 2014

Frankfurt, Germany

9–12

Torino, Italy

11th EANO Meeting of the European Association for Neurooncology

11–15 Anesthesiology 2014

New Orleans, United States

Milan, Italy

11–15

European Association of Cardiothoracic Surgery

Main International Conferences

9

Main International Conferences 2014 Month Date Conference

Location

Month Date Conference

Location

25–28

Barcelona, Spain

16th World Congress of Psychiatry

Madrid, Spain

15–19

50th EASD Annual Meeting – the European Association for the Study of Diabetes

Tel Aviv, Israel

17–19

14th International Congress of Cardiothoracic and Vascular Anaesthesia (EACTA Annual Meeting 2014)

Florence, Italy

16th World Congress on Gastrointestinal Cancer (ESMO 2014)

26–28 International Symposium on Supportive Care in Cancer

Miami, United States

July

5–8

23rd EACR – European Association for Cancer Research

Munich, Germany

6–9

5th International Congress of Psoriasis 2014

Paris, France

12–17 Alzheimer’s Association International Conference

Copenhagen, Denmark

20–25 AIDS 2014

Melbourne, Australia

25–28

Boston, United States

International Academy of Cardiology, Annual Scientific Sessions 2014, 19th World Congress on Heart Disease

28–30 3rd International Conference on Gastroenterology & Urology San Antonio, United States August

21–23

6th Latin American Conference on Lung Cancer (LALCA)

30–3 Sep European Society of Cardiology Congress 2014

Lima, Peru Barcelona, Spain

30– 3 Sep 26th European Congress of Pathology (ECP 2014)

London, United Kingdom

September 2–4

Maastricht, Netherlands

53rd Annual Scientific Meeting of the International Spinal Cord Society

3–6 15th World Congress on Cancers of the Skin

Edinburgh, United Kingdom

4–7

World Congress on NeuroTherapeutics

Basel, Switzerland

6–10

European Respiratory Society Annual Congress

Munich, Germany

10–13

European Association for Behavioural & Cognitive Therapies Congress 2014

The Hague, Netherlands

12–14

2014 Chinese Congress and Exposition on Gerontology and Health Industry

Suzhou, China

8

Global Healthcare Report Supplement

14–18

18–21 1st Euro–Asian Melanoma Congress

Sarajevo, Bosnia And Herzegovina

22–25

Stockholm, Sweden

European Society for Vascular Surgery – 28th Annual Meeting

24–27 Southern African HIV Clinicians Society Conference 2014

Cape Town, South Africa

25–27

International Conference on Repair, Regeneration and Reconstruction

London, United Kingdom

26–30 27–1 Oct

39th ESMO Congress – the European Society for Medical Oncology

Madrid, Spain

LIVES 2014 – the European Society of Intensive Care Medicine (ESICM) Congress

Barcelona, Spain

October

Eurospine 2014

Lyon, France

1–3

5–8 Heart Rhythm Congress 2014

Birmingham, United Kingdom

9–11

Atlanta, United States

28th Annual North American Cystic Fibrosis (NACF) Conference

9–11 The Viral Hepatitis Congress 2014

Frankfurt, Germany

9–12

Torino, Italy

11th EANO Meeting of the European Association for Neurooncology

11–15 Anesthesiology 2014

New Orleans, United States

Milan, Italy

11–15

European Association of Cardiothoracic Surgery

Main International Conferences

9

Main International Conferences 2014 Month Date Conference

Location

Month Date Conference

Location

12–17 EANS 15th European Congress of Neurosurgery 2014

Prague, Czech Republic

EORTC-NCI-AACR 2014

Barcelona, Spain

16–19 The 18th SIS World Congress on Breast Healthcare

Orlando, United States

4th World Congress of Regional Anaesthesia and Pain Therapy

Cape Town, South Africa

20–22 24th Alzheimer Europe Conference

Glasgow, United Kingdom

22–25 2014 Cardiometabolic Health Congress (CMHC)

Boston, United States

9th World Stroke Congress

26–30 29–31

18–21

24–28

26–28 Vascular Society Annual General Meeting 2014

Glasgow, United Kingdom

26–29

DGPPN Congress 2014 – the German Association of Psychiatry, Psychotherapy and Psychosomatics

Berlin, Germany

Istanbul, Turkey

27–28

BSHF 17th Annual Autumn Meeting – the British Society for Heart Failure

London, United Kingdom

100th Annual American College of Surgeons Clinical Congress (2014)

San Francisco, United States

December 3–6 World Cancer Congress 2014

Melbourne, Australia

34th Congress of the European Society of Surgical Oncology (ESSO) in partnership with BASO 2014

Liverpool, United Kingdom

3–6

24th World Congress of the International. Association of Surgeons,. Gastroenterologists and Oncologists

Vienna, Austria

November 2–6 HIV Glasgow 2014

Glasgow, United Kingdom

4–7

10th International Congress on Non-Motor Dysfunctions in Parkinson’s Disease and Related Disorders

Nice, France

6–9

2014 ASDS Annual Meeting (American Society for Dermatologic Surgery)

San Diego, United States

4–7

20th World Congress on Controversies in Obstetrics, Gynecology & Infertility (COGI)

Paris, France

HIV Drug Therapy in the Americas 2014

Sao Paulo, Brazil

The 2nd World Congress on Clinical Lipidology

Vienna, Austria

8–10

5th International Conference on Stem Cells and Cancer (ICSCC–2014)

New Delhi, India

8–11

15th Biennial Meeting of the International Gynecologic Cancer Society

Melbourne, Australia

22–25

7–10

9–13 9th International Respiratory Syncytial virus Symposium

Cape Town, South Africa

10–12

Tel Aviv, Israel

7th International Congress for Gender and Sex Specific Medicine

13–15 22nd World Congress on Social Psychiatry

London, United Kingdom

15–19 Society for Neuroscience 2014 Annual Meeting

Washington D.C., United States

10

Global Healthcare Report Supplement

5–7

Main International Conferences

11

Main International Conferences 2014 Month Date Conference

Location

Month Date Conference

Location

12–17 EANS 15th European Congress of Neurosurgery 2014

Prague, Czech Republic

EORTC-NCI-AACR 2014

Barcelona, Spain

16–19 The 18th SIS World Congress on Breast Healthcare

Orlando, United States

4th World Congress of Regional Anaesthesia and Pain Therapy

Cape Town, South Africa

20–22 24th Alzheimer Europe Conference

Glasgow, United Kingdom

22–25 2014 Cardiometabolic Health Congress (CMHC)

Boston, United States

9th World Stroke Congress

26–30 29–31

18–21

24–28

26–28 Vascular Society Annual General Meeting 2014

Glasgow, United Kingdom

26–29

DGPPN Congress 2014 – the German Association of Psychiatry, Psychotherapy and Psychosomatics

Berlin, Germany

Istanbul, Turkey

27–28

BSHF 17th Annual Autumn Meeting – the British Society for Heart Failure

London, United Kingdom

100th Annual American College of Surgeons Clinical Congress (2014)

San Francisco, United States

December 3–6 World Cancer Congress 2014

Melbourne, Australia

34th Congress of the European Society of Surgical Oncology (ESSO) in partnership with BASO 2014

Liverpool, United Kingdom

3–6

24th World Congress of the International. Association of Surgeons,. Gastroenterologists and Oncologists

Vienna, Austria

November 2–6 HIV Glasgow 2014

Glasgow, United Kingdom

4–7

10th International Congress on Non-Motor Dysfunctions in Parkinson’s Disease and Related Disorders

Nice, France

6–9

2014 ASDS Annual Meeting (American Society for Dermatologic Surgery)

San Diego, United States

4–7

20th World Congress on Controversies in Obstetrics, Gynecology & Infertility (COGI)

Paris, France

HIV Drug Therapy in the Americas 2014

Sao Paulo, Brazil

The 2nd World Congress on Clinical Lipidology

Vienna, Austria

8–10

5th International Conference on Stem Cells and Cancer (ICSCC–2014)

New Delhi, India

8–11

15th Biennial Meeting of the International Gynecologic Cancer Society

Melbourne, Australia

22–25

7–10

9–13 9th International Respiratory Syncytial virus Symposium

Cape Town, South Africa

10–12

Tel Aviv, Israel

7th International Congress for Gender and Sex Specific Medicine

13–15 22nd World Congress on Social Psychiatry

London, United Kingdom

15–19 Society for Neuroscience 2014 Annual Meeting

Washington D.C., United States

10

Global Healthcare Report Supplement

5–7

Main International Conferences

11

Workforce Counts Brazil 11,4315

Canada

China

GPs

38,212

376,102

190

1,342

Allergologists

*

*

2,160

16,771

Anaesthesiologists

3,144

21,11

1,518

Cardiac surgeons

349

1,110

17,256

Cardiologists

705

757

7,054

249

204/229

GPs

Argentina Australia Austria Belgium 14,529 8,552 25,421 22,781

Allergologists

923

105

2

Anaesthesiologists

4,681

3,458

2,279

Cardiac surgeons

*

177

10

Cardiologists

9070

804

435

Dermatologists

5,110

403

Diabet./Endocr.

2,741

386

418 1,022 1,055 Emergency Physicians 695 615 393 2,608 ENT

Croatia

Czech Rep

Denmark

5,446

5,730

*

472

51

722

2,024

1,200

*

*

180

*

1,288

*

*

976

656

Dermatologists

577

*

160

875

241

4,514

Diabet./Endocr.

451

*

*

562

344

5,227

* 852 74 Emergency Physicians * 1,001 * 715 ENT

174 455

Gastroenterologists

671

591

414

667

6,623

Gastroenterologists

703

*

*

445

252

General Surgeons

4,578

4,125

1,464

1,652

34,926

General Surgeons

1,835

*

714

2,703

910

*

308

1,957

Geriatricians

260

*

532

176

315

205

2,341

Haematologists

385

*

542

196

3

39

2,949

Infectious Diseases Specialist

266

*

254

163

Internal Medicine

8,431

*

1342

4,024

1,731

Geriatricians Haematologists

628

240

Infectious Diseases Specialist

*

Internal Medicine

2,129

242

3,468

1,322

Nephrologists

824

285

221

314

3,875

Nephrologists

612

*

*

213

187

Neurologists

724

408

695

451

6,670

Neurologists

886

*

370

1,588

309

Neurosurgeons

511

165

196

196

3,048

Neurosurgeons

312

21,11

84

212

122

Ob/Gyn

3,770

1,380

1,654

1,509

32,934

Ob/Gyn

1,918

114,657

565

2,581

792

Oncologists

564

265

17

502

3,824

Oncologists

487

*

99

317

440

Ophthalmologists

2,858

803

796

939

11,446

Ophthalmologists

1,186

10,554

351

1,295

415

Orthopaedists

3,480

953

821

1,076

9,332

Orthopaedists

1,517

*

208

1,211

1,096

1,098

287

342

*

420

Pathologists

Pathologists

Paediatricians

14,255

1,276

1,183

1,643

37,939

Paediatricians

2,458

*

598

2,119

604

Psychiatrists

1,952

2,568

895

1,819

7,798

Psychiatrists

4,169

15,831

554

1,509

1,241

Pulmonologists

*

229

384

480

3,902

Pulmonologists

672

*

*

652

246

Radiologists

2,129

*

525

1,307

14,765

Radiologists

2,389

31,663

568

1,477

636

Rheumatologists

497

221

249

255

1,971

Rheumatologists

366

*

*

196

348

Urologists

1,500

296

512

413

4,921

Urologists

670

*

178

680

255

*Official information not available Counts might also include specialists with a sub specialty or special interest where applicable. Please contact us for any questions. 12

Global Healthcare Report Supplement

Sources • Cegedim and Physician Associations (Denmark, Belgium) • Croatian Health Service Yearbook 2012 published by Croatian National Institute of Public Health (HZJZ).

• Institute of Health Information and Statistics of the Czech Republic. Data valid for the end of 2012/beginning of 2013. • Medical Associations (Argentina and Columbia) • Secretary of Health (Brazil) Workforce Counts

13

Workforce Counts Brazil 11,4315

Canada

China

GPs

38,212

376,102

190

1,342

Allergologists

*

*

2,160

16,771

Anaesthesiologists

3,144

21,11

1,518

Cardiac surgeons

349

1,110

17,256

Cardiologists

705

757

7,054

249

204/229

GPs

Argentina Australia Austria Belgium 14,529 8,552 25,421 22,781

Allergologists

923

105

2

Anaesthesiologists

4,681

3,458

2,279

Cardiac surgeons

*

177

10

Cardiologists

9070

804

435

Dermatologists

5,110

403

Diabet./Endocr.

2,741

386

418 1,022 1,055 Emergency Physicians 695 615 393 2,608 ENT

Croatia

Czech Rep

Denmark

5,446

5,730

*

472

51

722

2,024

1,200

*

*

180

*

1,288

*

*

976

656

Dermatologists

577

*

160

875

241

4,514

Diabet./Endocr.

451

*

*

562

344

5,227

* 852 74 Emergency Physicians * 1,001 * 715 ENT

174 455

Gastroenterologists

671

591

414

667

6,623

Gastroenterologists

703

*

*

445

252

General Surgeons

4,578

4,125

1,464

1,652

34,926

General Surgeons

1,835

*

714

2,703

910

*

308

1,957

Geriatricians

260

*

532

176

315

205

2,341

Haematologists

385

*

542

196

3

39

2,949

Infectious Diseases Specialist

266

*

254

163

Internal Medicine

8,431

*

1342

4,024

1,731

Geriatricians Haematologists

628

240

Infectious Diseases Specialist

*

Internal Medicine

2,129

242

3,468

1,322

Nephrologists

824

285

221

314

3,875

Nephrologists

612

*

*

213

187

Neurologists

724

408

695

451

6,670

Neurologists

886

*

370

1,588

309

Neurosurgeons

511

165

196

196

3,048

Neurosurgeons

312

21,11

84

212

122

Ob/Gyn

3,770

1,380

1,654

1,509

32,934

Ob/Gyn

1,918

114,657

565

2,581

792

Oncologists

564

265

17

502

3,824

Oncologists

487

*

99

317

440

Ophthalmologists

2,858

803

796

939

11,446

Ophthalmologists

1,186

10,554

351

1,295

415

Orthopaedists

3,480

953

821

1,076

9,332

Orthopaedists

1,517

*

208

1,211

1,096

1,098

287

342

*

420

Pathologists

Pathologists

Paediatricians

14,255

1,276

1,183

1,643

37,939

Paediatricians

2,458

*

598

2,119

604

Psychiatrists

1,952

2,568

895

1,819

7,798

Psychiatrists

4,169

15,831

554

1,509

1,241

Pulmonologists

*

229

384

480

3,902

Pulmonologists

672

*

*

652

246

Radiologists

2,129

*

525

1,307

14,765

Radiologists

2,389

31,663

568

1,477

636

Rheumatologists

497

221

249

255

1,971

Rheumatologists

366

*

*

196

348

Urologists

1,500

296

512

413

4,921

Urologists

670

*

178

680

255

*Official information not available Counts might also include specialists with a sub specialty or special interest where applicable. Please contact us for any questions. 12

Global Healthcare Report Supplement

Sources • Cegedim and Physician Associations (Denmark, Belgium) • Croatian Health Service Yearbook 2012 published by Croatian National Institute of Public Health (HZJZ).

• Institute of Health Information and Statistics of the Czech Republic. Data valid for the end of 2012/beginning of 2013. • Medical Associations (Argentina and Columbia) • Secretary of Health (Brazil) Workforce Counts

13

Workforce Counts Germany

Greece

Hungary

India

Ireland

Italy

43,248

3,500

6,463

GPs

630,937

3,318

46,061

6,424

180

196

Allergologists

*

15

1,785

203

10

21,478

1,680

1,131

Anaesthesiologists

26,679

389

10,746

8,140

77

393

904

526

*

Cardiac surgeons

15

38

589

2,893

219

6,710

5,450

2,820

678

Cardiologists

91

42

14,912

11,541

59

193

4,104

5,584

1,092

458

Dermatologists

2,134

30

4,977

8,686

4

130

1,737

613

542

*

Diabet./Endocr.

*

39

6,589

3,967

3/18

468

Emergency Physicians 6,337 51 * 9,087 ENT

Finland

France 101,803

GPs

3,012

Allergologists

143

Anaesthesiologists

760

10,841

Cardiac surgeons

*

Cardiologists Dermatologists Diabet./Endocr.

8 188 Emergency Physicians 3,056 333 5,952 1,209 ENT

Japan

Luxembourg 484

6 35

Gastroenterologists

107

3,556

3,198

720

400

Gastroenterologists

*

53

6,661

13,080

31

General Surgeons

1,558

3,628

10,460

2,992

1,019

General Surgeons

*

312

14,208

16,083

63

Geriatricians

213

1,404

92

*

Haematologists

85

477

2,160

443

*

91

4,431

2,353

11

Infectious Diseases Specialist

92

273

250

367