Measuring%20health%20care%20quality%20at%20the%20international%20level:%20%20Introduction%20to%20the%20OECD%20Health%20Care%20Quality%20Indicators%20Project

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Measuring health care quality at the
international level Introduction to the OECD
Health Care Quality Indicators Project

• Peter Scherer
• Head, Health Division
• OECD Patient Safety Seminar Safety Data for
  Safer Care
• Dublin June 29-30, 2006

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Presentation Outline

• Purpose and basis for HCQI Project
• Recent progress
• Next Steps Updating Data and Developing
  Indicators

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Broad purpose of OECDs HCQI Project

• Develop indicator set - to raise questions
  about quality of health care across countries
• Initial attention - technical quality of health
  care (i.e. effectiveness)
• Future consideration of other areas (e.g.
  Responsiveness/patient centeredness)
• To be representative of the main disease and risk
  groups in participating countries

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HCQI Foundation
Analysis of available measures and consensus
efforts

• 1. Application of scientific criteria for
  indicators
• Scientific soundness
• Clinical and policy importance
• Feasibility of measurement
• 2. Review balance of measure set
• Structure, process and outcomes

HCQI Initial Measure Set
The Nordic Council of Ministers
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Regular annual Collection
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HCQI Progress

• Project reports and dissemination -
• OECD Health Working Paper 22 HCQI Initial
  Indicators Report (2006)
• OECD Health Working Paper 23 HCQI Conceptual
  Framework Paper (2006)
• International Journal for Quality in Health Care
  HCQI supplement, Fall 2006
• European Conference on Health Economics,
  Budapest, Hungary (2006)
• European Health Forum, Gastein, Austria (2005)
• International Scientific Basis of Health
  Services, Montreal, Canada (2005)
• UK EU Presidency Summit on Patient Safety,
  London, UK (2005)

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HCQI Initial Indicators Report Data
Comparability Analyses

• Data comparability questions investigated
• What is the appropriate reference population for
  age adjustment?
• What is the impact of different policies for
  handling missing data?
• What is the impact of notification policies on
  cases of vaccine-preventable disease?
• What is the impact of variation in coding
  practices (for asthma)?
• What is the effect of unique identifiers when
  dealing with mortality rates?

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Results from the HCQI Initial Indicators Report

• No country best or worst in all indicators
• Most countries exhibit areas of possible best
  practices
• All indicators raise questions for possible
  future investigation about why differences in
  quality exist

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Next Steps

• Examine differences across countries
• Improve the indicator set
• Lay foundation for future indicator development
  through country subgroups

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Improving and Updating the Measure Set

• Recommendations will be result of work five
  priority areas selected by OECD countries.
• Priority areas patient safety, mental health
  care, cardiac care, diabetes care and primary
  care and prevention.
• Expert Subgroups formed in patient safety and
  mental health
• Subgroup teleconferences held April 2006
  (approximately 10-15 countries in each group.)
• Major meetings of these groups are planned
• Dublin, Ireland June 29-30, 2006 OECD Patient
  Safety Seminar, Safety Data for Safer Care.
• November 2006 OECDs Mental Health Expert
  Subgroup.
• Similar work is planned in 2007 on cardiac care
  and diabetes care.
• Preliminary work has also been begun in 2006 on
  indicators of responsiveness.

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Contact information

• Dr. Peter SchererHead Health DivisionOECDpeter
  .scherer_at_oecd.org
• Dr. Edward KelleyHead, Health Care Quality
  Indicators ProjectOECDedward.kelley_at_oecd.org33
  -1-4524-9239

• Web site
• OECD Health Care Quality Indicators
  www.oecd.org/health