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Immigrants are more likely to have advanced degrees than the natural citizens and immigrants especially from Asia are dominant in the highly skilled and educated world as a group with one of the highest numbers of PhD holders.
In September 2012, the Organization for Economic Cooperation & Development (OECD) published a report showing comparative education data among the 34 OECD member nations.
According to the report, Israel ranked second in terms of percentage of population aged 25-64 that have attained tertiary education, behind only Canada. Highest Education Level Attained (Populations Age 25+): The data represents the percentage of people in the area over age 25 who have attained a particular education level. Education Index: The Education Index for Zip Codes and places are comprised of a combination of socio-demographic characteristics. Education Enrollment (Population Age 3+): The data represents the percentage of people in the area over age 3 who are currently enrolled at each type of learning institution. Index score: (100 = National Average) for an area is compared to the national average of 100. In the United States, the number of medical graduates increased by 28% between 2000 and 2014, whereas the number of nursing graduates more than doubled during that period in response to concerns around 2000 that there might be a big shortage of nurses in the years ahead. The steady rise in the number of new medical and nursing graduates over the past 15 years, combined with the immigration of foreign-trained doctors and nurses in some countries, has generally exceeded the number of doctors and nurses leaving the profession. Inpatient and outpatient medical services, as well as ancillary services (imaging and lab tests) are better covered by basic health coverage schemes than other types of care. Prior to 2000, increased spending on retail pharmaceuticals acted a major contributor in driving up overall health expenditure and, as a consequence, the health sector share of GDP.
Across OECD countries, pharmaceutical spending reached around USD 800 billion in 2013, accounting for about 20% of total health spending on average when pharmaceutical consumption in hospital is added to the purchase of pharmaceutical drugs in the retail sector. The paper then looks at emerging challenges for policy makers in the management of pharmaceutical spending. Many older people who need long-term (LTC) care prefer to remain in their own home for as long as possible, and most OECD countries aim to support them to do so. While an increase in home care is a positive change that can help people to remain independent and engaged with their community, it does create some new challenges.
There is also some evidence that severely dependent people, especially those with dementia, can be at greater risk of hospitalisation when living in their own home, compared to being in an institution. Employment in the health and social sector represents a large and growing share of total employment in many OECD countries. 1 - Short life expectancy and high cancer mortality: people die relatively early and a lot of them die of cancer. 2 - Short life expectancy and low cancer mortality: people die relatively early but it tends to be of causes other than cancer. 3 - Long life expectancy and high cancer mortality: as all-cause mortality reduces and people live longer, cancer risks increase. Note: Due to different definition and identification of emergency care services caution is needed when comparing OECD countries.
Emergency department visits are more frequent in the very young and the very old, while injury diagnoses constitute one of the most common reasons for visiting hospital emergency departments. Timely surgery can be considered an indicator of the quality of acute care received by patients with hip fracture. Looking at the proportion of hip-fracture repairs occurring within two days of admission in OECD countries between 2003 and 2013, the OECD average has increased from 76% to 81%. The international migration of doctors has drawn a lot of attention in recent years because of concerns that it might exacerbate shortages of skilled health workers in certain countries, particularly in developing countries that are already suffering from critical workforce shortages. Since 2000, the number and share of foreign-trained doctors has increased in many OECD countries. Nearly 50% of foreign-trained doctors working in the United States come from Asian countries, with those coming from India representing by far the largest number, followed by the Philippines and Pakistan. In OECD countries, three quarters of health expenditures on average are paid by public sources, but about 20% of expenditures are paid directly by households, though this share varies greatly from one country to another. The remuneration level of nurses is one of the factors affecting their job satisfaction and the attractiveness of the profession. In many countries, the remuneration of nurses has been affected by the economic crisis in 2008, but to varying degrees.
Caesarean section rates have increased in most OECD countries, with the average rate going up from 20% in 2000 to 28% in 2013. This rate is three times higher than in Nordic countries (Iceland, Finland, Sweden, Norway) and in Israel and the Netherlands. Non-medically required caesarean sections result in higher risk of maternal mortality, increased maternal and infant morbidity, increased complications for subsequent deliveries, and higher costs.
Cancer is the second leading cause of death in OECD countries after cardiovascular diseases, accounting for 25% of all deaths in 2013.
Lung cancer is still by far the most common cause of death from cancer among men (26%), followed by colorectal cancer (11%) and prostate cancer (9%). There have been huge gains in life expectancy across OECD countries over the past decades, but large disparities remain across socio-economic groups. The economic crisis had a significant impact on health spending growth in many EU countries, resulting in substantially lower spending growth since 2009. Both inpatient and outpatient care saw average spending growth decrease significantly, especially from 2010 onwards, in contrast to the high growth rates seen prior to the economic crisis. The strong increase in 2009 is due partially to the H1N1 influenza pandemic which led to significant one-off expenditures for the purchase of large stocks of vaccines in many countries.
Ageing societies present new challenges, such as the rising prevalence of age-related conditions like dementia. The development of same-day surgery is made possible by continuous improvements in anaesthetics and surgical techniques, and is seen as an important way to achieve efficiency gains in health care delivery by reducing the cost per intervention.

A cataract surgery using modern techniques should not normally require any hospitalisation, except in rare cases. A coronary angioplasty is the most common procedure to treat patients suffering from ischaemic heart disease (obstructed arteries). Population ageing reflects the success of health and development policies over the last few decades. In most European countries, the absolute number of doctors has increased both before and after the 2008-09 economic crisis, although the number has stabilised in some countries hard hit by the recession such as Greece. All OECD countries see the development of generic markets as a good opportunity to increase efficiency in pharmaceutical spending, by offering cheaper products than on-patent drugs for an equivalent health outcome. The share of the generic market in value is always lower than in volume, due to the fact that prices of generics are lower than for on-patent drugs.
Note: The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. These index scores are not based statistically upon the performance of specific schools, programs or colleges located in these areas. A score of 200 indicates twice the national average, while 50 indicates half the national average.
As a result, the number of medical and nursing graduates has grown steadily, so that the overall number of medical graduates across the 35 OECD countries was 32% higher in 2014 than in 2000, while the number of nursing graduates grew even faster by 76% between 2000 and 2014.
There has also been strong growth across the 22 EU countries that are OECD members, with the number of medical graduates rising by 37% between 2000 and 2014 and the number of nursing graduates by 48%. This explains why the number of doctors and nurses, both in absolute numbers and on a per capita basis, has increased since 2000 in nearly all OECD countries. Further analysis is available in Chapter 3 in "Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places"(2016). Coverage for pharmaceutical spending is typically lower, due to often-higher cost-sharing and the possibility of self-consumption.
In Germany these estimations were not possible to produce; other countries did not provide data. Particularly during the 1990s and early 2000s, average real annual growth in pharmaceutical spending outpaced overall health spending growth. The OECD Working Paper looks at recent trends in pharmaceutical spending across OECD countries. The proliferation of high-cost specialty medicines will be a major driver of health spending growth in the coming years. Over the last decade, nearly all countries for which we have data have seen an increase in the proportion of LTC users living at home, with particularly large shifts in France, Sweden and Korea. People with LTC needs living at home are usually cared for, at least in part, by their family and friends. On average, health and social work accounted for more than 10% of total employment in OECD countries in 2014, up from less than 9% in 2000. The number of ED visits has increased over time in almost all OECD countries over the past decade. But the good news is that death rates from transport accidents have come down steadily in nearly all OECD countries. The adoption of new laws and the enforcement of these laws to improve compliance with speed limits, seatbelt use and drink-driving rules can help in further reducing the burden of road transport accidents. The greatest improvement was observed in Italy, where the proportion increased from 28% in 2008 to 45% in 2013, and in Israel, where it increased from 70% in 2003 to 85% in 2013.
The Global Code of Practice on the International Recruitment of Health Personnel, adopted by the World Health Assembly in May 2010, was designed to respond to these concerns. More than 10% of doctors were trained in the Caribbean Islands, but in many cases these were American students who went to study abroad and then came back to the United States to complete their post-graduate training and practice. It also has a direct impact on costs, as wages represent one of the main spending items in health systems. Outside Europe, the growth in the remuneration of nurses in countries such as the United States, Australia and New Zealand slowed down temporarily following the economic crisis, while the crisis did not appear to have any effect on the growth rate in nurse remuneration level in Mexico. The rise has been particularly strong in middle-income countries like Turkey, Mexico and Chile, where c-section rates now accounts for 45% or more of all deliveries.
Italy provides an example of a country that has been able to reverse the previous trend of rising c-section rates, although there is still room for further reduction particularly in those Italian regions where the rate remains very high.
Lung cancer is also the most common cause of cancer mortality among women (17%), followed by breast cancer (15%) and colorectal cancer (12%). At age 30, women with the highest level of education can expect to live four years longer than those with the lowest level of education on average across OECD countries, while the gap reaches almost eight years between the most educated and least educated men.
The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law.
The slowdown in health expenditure affected all health spending categories to varying degrees.
Pharmaceutical spending has continued to shrink, on average, for the last three years from 2010 to 2012, mainly due to government price reduction policies. Administration was another category immediately targeted in cost-cutting efforts, although administrative cost has started to grow again in many countries in 2012. If age-specific prevalence rates are assumed to remain constant, demographic change has led to a 50% increase in overall prevalence in Europe over the last 20 years and we should expect a similar increase in the next 20 years.
Nearly all cataract surgeries are performed on a same-day basis in many OECD countries, including in Canada, Belgium, the Netherlands, Spain, Sweden and the United Kingdom. Although the operation is performed under general anesthesia, it is carried out mainly as a same-day surgery in many countries, including Belgium, Canada, the Netherlands and Sweden. In all countries, this procedure usually involves keeping the patient at least one night in hospital, although some countries have seen a development of this procedure on a same-day basis also.

Data for more countries are available in the dataset on Health Care Utilisation, query "Surgical procedures (shortlist)".Access the data behind the graphs. The share of the population aged over 65 years in Asian countries was 7%, less than half the level in OECD countries in 2012.
However, in 2012, generics accounted for about three-quarter of the volume of pharmaceuticals covered by basic health coverage in the United Kingdom, Germany, New Zealand and Denmark, while they represented less than one-quarter of the market in Luxembourg, Switzerland, Greece, Italy, Japan and Ireland. The increase has been more modest in Japan and Korea, with a rise of 7% in the number of medical graduates and 35% in the number of nursing graduates in these two Asian countries. Basic health coverage schemes cover about half of spending in dental care in a handful of countries (Austria, Belgium, Czech Republic, Luxembourg, Slovak Republic, and Slovenia) and three-quarter in Japan. Outpatient primary and specialist care data do not include dental care; transport is not included in ancillary services. However, during the 2000s there was a notable shift with a significant drop in average pharmaceutical growth during the second half of the decade which intensified through the global economic crisis.
It examines the drivers of recent spending trends, highlighting differences across therapeutic classes.
While some of these medicines bring great benefits to patients, others provide only marginal improvements. This can put a strain on those providing care, which can affect their health and make it difficult for them to work.
This employment share is particularly large in Nordic countries and the Netherlands, where jobs in health and social work represent 15-20% of total jobs.
Since 1990, the average OECD mortality rates due to transport accidents has fallen by more than 70%.
Most foreign-trained doctors in the United Kingdom also came from Asian countries, with India also leading by a wide margin, although a growing number of foreign-trained doctors now come from other EU countries. In Europe, following the economic crisis, the remuneration of nurses was cut down in some countries, such as in Hungary and Italy, and has been frozen in Italy over the past few years. Differences in life expectancy by education level are particularly large in Central European countries, especially among men.
Many countries also took early measures to reduce or postpone spending on prevention and public health services, with a slight recovery in spending observed since 2011.
Dementia remains relatively rare in working age adults, with between 2% and 10% of cases starting before the age of 65 (World Health Organization, 2012a).
In France and Italy, the share of cataract surgeries performed as day cases has increased rapidly over the past ten years and accounted for over 80% of the total in 2012, but there is still some way to go in these two countries to move closer to 100%. However, in France, Italy and Spain, only between 20% to 30% of children and other people having a tonsillectomy return home the same day. In the Netherlands and the United Kingdom, the share of coronary angioplasties performed as day cases now exceeds 20%, while such procedures remain almost non-existent in France and Italy.
But it is expected to nearly quadruple in the next four decades to reach 26% in 2050, surpassing the OECD average of 25%.
Looking at the entire period from 2000 to 2012, there were 50% more doctors in the United Kingdom in 2012 compared with 2000. They are highest in Australia, Switzerland, Finland, Canada and Germany (above 200 per 100 000 population over 15-years old) while they are below 150 in other countries, with Israel having the lowest rate (56 per 100 000). While the consumption of medicines continues to increase and to push pharmaceutical spending up, cost-containment policies and patent expiries of a number of top-selling products have exerted downward pressure on pharmaceutical expenditures in recent years. A shift towards care at home means that policies to support carers are more important than ever. While the rise in the number of visits is recorded in 14 countries out of 22, the numbers of ED visits has decreased in Chile, Israel, Poland, the Czech Republic and Ireland. Still, there remain considerable variation across countries, with transport accidents claiming more than five times as many lives per 100 000 population in Mexico compared to the United Kingdom. In Greece, the remuneration of nurses has been reduced on average by 20% between 2009 and 2013. This is largely explained by the greater prevalence of risk factors among men, including greater tobacco and alcohol use. However, after the age of 80, prevalence increases steeply and nearly half of all Europeans over the age of 95 have dementia. The growth in the share of the population aged 80 years and over will be even more dramatic.
In the Netherlands also, the number of doctor has increased steadily since 2000, and there were over one-third more doctors in 2011 (latest year available) compared with 2000. Knee replacements also vary by two- to three-fold across geographic areas in most countries; and vary by more than five-fold in Canada, Portugal and Spain. Mortality rates from road transport accidents also remain relatively high in Chile and the United States. On average across Asian countries, 1% of the population were aged 80 years and over in 2012 but in 2050, the percentage is expected to increase to 6%.
In Germany, the number of doctors has increased slightly more rapidly since 2008 than between 2000 and 2008; overall, there were about 20% more doctors in 2012 compared with 2000. In these three countries, however, large variations are partly explained by outliers with very low rates (Spain and Portugal) or with both high and low rates (Canada). In Japan, the proportion is expected to more than double from 7% to 16% between 2012 and 2050, but several other countries are likely to experience faster growth. Low rates in Spain and Portugal may be partly explained by partial coverage of data, which only include public hospitals.

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