Scandinavian Working Papers in Economics

HERO Online Working Paper Series,
University of Oslo, Health Economics Research Programme

No 2002:15: What is best and at what cost? Cross-national differences in the treatment of ageing-related diseases Norwegian perspective from a comparative OECD-project

Grete Botten () and Terje P. Hagen ()
Additional contact information
Grete Botten: Institute of Health Management and Health Economics, Postal: P.O. Box 1089 Blindern, NO-0317 Oslo, Norway
Terje P. Hagen: Institute of Health Management and Health Economics, Postal: P.O. Box 1089 Blindern, NO-0317 Oslo, Norway

Abstract: Aggregated medical spending differs widely across countries and large variations exist in the frequency and the mix of medical services provided, as well as the type of technology applied. The outcomes (mostly measured as survival rates) do not, however vary to the same extent as the spending. Policy makers in many countries compare their spending to each other, with no clear consensus about how systems are effective in treating patients. In each of these debates the issue of what medical care is buying arises: When countries spend more or less on health care, how does that affect resource allocation in the medical sector and ultimately the health outcomes? The goal of the project1 was to examine how different medical care systems will affect the allocation of resources in the medical sector. As the existing available macro data at an international level does not allow for satisfactory answers to such questions, this project wanted to use a microeconomic approach. An international comparison of treatments of conditions in older populations that lead to high expenditures could help to identify treatments that might be more effective in improving outcomes at lower cost. Therefore the project focused on international comparisons of treatments for a spectrum of conditions in older populations with high aggregate medical spending, well identified episodes of care, high prevalence and high policy relevance. Norway participated in studies on myocardial infarction and breast cancer 2. The choice of focus on older patients was partly motivated by the fact that in the future the elderly will probably take an increasingly proportion of the total spending in the health care sector. See documentation from the main project:,,EN-document-194-5-no-27-32316-0,00.html

Keywords: Medical care; allocation of resources; acute myocardial infarction; breast cancer; international comparisons of treatments

JEL-codes: I18

66 pages, June 29, 2009

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