Annex A. Methodology

OECD assessed several case study interventions to promote integrated care. Together, the case studies cover several OECD and non-OECD European countries.

Selected case studies represent strategic, high-priority interventions among policy makers in the OECD and EU27.

This section outlines two complementary frameworks used to assess case studies, both of which were developed by the OECD – the Best Practice Framework and the Transferability Framework. Limitations associated with the analysis are also discussed.

The Best Practice Framework outlines five criteria to assess whether an intervention is “best practice” – namely Effectiveness, Efficiency, Equity, Evidence-base, and Extent of coverage (Table A A.2). A review of the academic and grey literature, existing best practice frameworks and feedback from delegates to OECD’s expert Group on the Economics of Public Health informed the selection of criteria.

An intervention can be awarded a “stamp of approval” against one or multiple criteria if it performs particularly well relative to similar interventions.picture

Up and coming interventions (i.e. those that show promise but have not yet collected any of their own data) can be awarded a “promising best practice” stamp of approval for relevant criteria.picture

Public health interventions are complex given they involve multiple stakeholders, often target heterogeneous groups, and have outcomes affected by various direct and indirect factors. Therefore, positive outcomes achieved in one setting aren’t necessarily transferable to a different setting.

OECD has developed a Transferability Framework to assist policy makers assess whether a best practice intervention can be transferred from where it has been implemented (i.e. best practice “owner setting”) to a different country/region (i.e. the “target setting”). Specifically, whether the desired outcomes achieved in the owner setting are achievable in the target setting (Trompette et al., 2014[]; Burchett, Umoquit and Dobrow, 2011[]).

The Transferability Framework includes four contextual factors that affect transferability:

  • Population context: covers population characteristics such as sociodemographic factors as well as broader cultural considerations

  • Sector specific context: covers governance/regulation, financing, workforce, capital and access arrangements in the sector the intervention operates

  • Political context: political will from key decision-makers to implement the intervention

  • Economic context: the affordability of the intervention in the target setting.

In each case study, indicators to assess transferability are grouped under one of these four contextual factors. For the case studies presented in this document, countries are allocated into a group based on how far the indicator’s value is from the best practice owner setting. This method is referred to as the “distance from reference country” and is explained in Box A A.1. In addition, OECD developed a clustering methodology to group countries according to their potential to transfer a best practice intervention (Box A A.2).

Indicators were sourced from international databases to maximise coverage across OECD and non-OECD European countries (e.g. OECD Stat, Eurostat, World Bank Indicators, and the WHO). Relevant indicators were excluded if data was missing for the best practice owner setting and could not be identified through desktop research, or, if more than 50% of data was missing across countries.

By using international data, the scope of the analysis was inevitably limited – i.e. indicators from international sources are high-level and don’t cover all relevant information for assessing transferability. Therefore, each case study also includes a set of “new indicators” (i.e. those with no publicly available information) policy makers should consider before transferring the intervention.


[2] Burchett, H., M. Umoquit and M. Dobrow (2011), How do we know when research from one setting can be useful in another? A review of external validity, applicability and transferability frameworks,

[3] OECD/European Union/EC-JRC (2008), Handbook on Constructing Composite Indicators: Methodology and User Guide, OECD Publishing, Paris,

[1] Trompette, J. et al. (2014), “Stakeholders’ perceptions of transferability criteria for health promotion interventions: A case study”, BMC Public Health, Vol. 14/1, pp. 1-11,

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