OECD Health Policy Studies

2074-319X (online)
2074-3181 (print)
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This series of publications analyses the organisation and performance of health systems, and factors explaining performance variations. Studies are conducted on such topics as co-ordination of care, pharmaceutical pricing, long-term care and disability, health workforce and international migration of health workers, information and communications technologies in health care, and the economics of prevention. 
Also available in French
Improving Value in Health Care

Improving Value in Health Care

Measuring Quality You do not have access to this content

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07 Oct 2010
9789264094819 (PDF) ;9789264094802(print)

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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. 

Many health policies depend on our ability to measure the quality of care accurately. Governments want to increase "patient-centeredness", improve co-ordination of care, and pay providers of high-quality care more than those who underperform. However, measuring the quality of health care is challenging. The OECD’s Health Care Quality Indicator project has overcome some of the problems, though many remain. If policy makers are serious about improving the body of evidence on the quality of care, they need to improve their health information systems.  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.

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  • Foreword
    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.
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  • Executive summary
    There is overwhelming evidence, from many countries, that health care is often not delivered in accordance with scientifically set and commonly-agreed professional standards. The result is that poor quality and unsafe care harms tens of thousands of people every year, and scarce health care resources are squandered. The good news is that many countries, which differ enormously in the way that their health systems are structured, are improving the quality of health care. Measuring quality is a first and essential step to reaching that goal.
  • Introduction
    The quality of health care has become a major focus of efforts to improve the health care systems. Measuring quality is the first step towards improving quality and thus value in health care. This is not merely a national but also an international challenge. In response to this challenge the OECD Health Care Quality Indicator Project (HCQI) was launched in 2003 and has since developed and tested a range of internationally comparable health care quality indicators covering various health care domains.
  • Why Do We Need Information on Health Care Quality?
    This chapter reviews why we need information on health care quality – to promote accountability, to inform policy development and to facilitate shared learning about quality improvement. The chapter also identifies key policies that have a bearing on quality-led governance and which rely on health care quality information.
  • What Does Existing Data on Health Quality Show?
    Using snapshots taken from the Health Care Quality Indicator Project, this chapter illustrates how health care quality information can be used to highlight quality variations, the conceptual and methodological challenges that arise when considering quality indicators, and finally the policy relevance of robust quality information.
  • How Can National Health Information Infrastructures Improve the Measurement of Quality of Care?
    Good information on health care quality requires systematic data collection and reporting capabilities. The following section reviews current state of health information systems and the challenges associated with their development.
  • How Can Quality Indicators Be Used for Health System Improvement?
    Using illustrative case studies taken from Belgium and Denmark, this chapter identifies the key touch points for quality improvement within health systems and discusses how health care quality indicators can be used proactively to improve quality.
  • Conclusions and Recommendations
    Health care systems today face tremendous challenges: complex care needs and care processes, increased health care demands especially for chronic conditions and perhaps most importantly, an economic landscape where health care systems will have to achieve more for less. Quality has a fundamental bearing on all these challenges. Poor quality of care undermines every goal of modern health systems. It results in poor patient satisfaction, excess morbidity and premature mortality, and increased health costs.
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