This report is about how to improve quality in health care – a vital objective for health systems everywhere. Quality in health care is multifaceted and has various perspectives. Every patient has a right to receive timely, safe and effective care. Patients also have a right to be informed about the care process and about its risk and benefits. Those who fund and manage health care have a duty to ensure that scarce health care resources are used judiciously and wisely for the greatest public good.
Are breast cancer survival rates higher in the United States than in the United Kingdom and France? Are a patient's chances of dying within 30 days after admission to a hospital with a heart attack lower in Canada than in Korea? Are surgeons in some countries more likely to leave "foreign bodies" behind after operations or make accidental punctures or lacerations rates when performing surgery? The need for answers to these kinds of questions and the value of measuring the quality of health care are among the issues addressed in this publication.
This publication describes what international comparable quality measures are currently available and how to link these measures to quality policies such as accreditation, practice guidelines, pay-for-performance, national safety programmes and quality reporting.
Table of Contents Acronyms Executive summary Introduction Chapter 1. Why Do We Need Information on Health Care Quality? 1.1. Co-ordination of care 1.2. Prevention 1.3. Patient-centered care 1.4. Health technology assessment (HTA) and clinical evaluations 1.5. Safety – the “quality chasm” persists 1.6. Pay for performance 1.7. Quality-led governance 1.8. The cross-national character of quality-led governance 1.9. Strategy-based quality indicator benchmarking systems Bibliography Chapter 2. What Does Existing Data on Health Quality Show? 2.1. OECD Health Care Quality Indicators (HCQI) Project: history and background 2.2. Primary care 2.3. Acute care for chronic conditions using coronary artery disease (CAD) as an example 2.4. Mental health 2.5. Cancer care 2.6. Patient safety 2.7. Patient experience Bibliography Chapter 3. How Can National Health Information Infrastructures Improve the Measurement of Quality of Care? 3.1. Reviewing developments in national health information infrastructures 3.2. The five main types of information sources for population-based quality indicators 3.3. Synthesising the lessons learned 3.4. Improving health information systems and data infrastructures 3.5. Promoting the information agenda Chapter 4. How Can Quality Indicators Be Used for Health System Improvement? 4.1. Health system inputs 4.2. Health system design 4.3. Health system and services monitoring 4.4. Health system improvement Bibliography Chapter 5. Conclusions and Recommendations