Health system performance on greenhouse gas emissions, climate change and development status in 38 OECD countries

Health systems must solve two climate-related problems simultaneously: mitigate their greenhouse gas emissions and adapt to additional patient loads associated with climate-induced demands for care from weather sequalae and vector-borne diseases. We aimed to benchmark the mitigation and adaptive efforts of OECD member countries compared with their health system performance. We used Multidimensional Scaling and Hierarchical Cluster Analysis to group all 38 OECD member countries as at January 2024. Clusters were defined according to greenhouse gases per capita, vulnerability to climate change and the United Nations' Human Development Index. Post hoc analyses compared each cluster's performance to the OECD's Health Care Quality Indicators. The countries fell into five profiles: Vulnerable low emitters; Vulnerable aspiring; Middle of the road; Robust aspiring; and Goldilocks zone. Post-hoc analyses revealed strong links between the profiles and health system performance. Characterising countries in a five-dimensional model may help policymakers to share benchmarked country-level information, devise ways to support resilient care practices, better target healthcare investments, and improve access to needed care.