European Health Forum Gastein Workshop International Quality Comparisons 6 October 2005 "Measuring the patient's perspective: Current and future work in Austria and the EU"

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 2 The presentation deals with  EU efforts to develop quality indicators  Austrian efforts to develop quality indicators in the context of international developments  The patients`perspective

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 3 The presentation will deal with  EU efforts to develop quality indicators  Austrian efforts to develop quality indicators in the context of international developments  The patients perspective

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 4 European Union - Who promotes quality indicators? Directorate General Health & Consumer Protection EU Health Monitoring Programme ( ) Pillar 1: establishment of a set of EC indicators ECHI I, II Project ( ) - demographic/socioeconomic factors - health status - determinants of health - health systems First set of ECHI indicators on the net PUBLIC HEALTH ACTION PROGRAMME ( ) Health Information and Knowledge System - Health Portal - Health Report - Health Indicators ECHI Shortlist June 2004 Health Care Quality/Performance Indicators: Regularily and comparably available indiactors: -Cancer survival rates; breast; cervix Partly available indicators: - waiting lists, for elective surgeries: e.g. hip replacement, cataract operation -surgical wound infections -stage at cancer diagnosis -diabetes monitoring Establishment of a DG-SANCO permanent Working Party on indicators

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 5 European Union - Who promotes quality indicators? Directorate General Employment & Social Affairs Communication (2003)261 Strengthening the social dimension of the Lisbon strategy:streamlining open coordination in the field of social protection Communication (2004)304 Modernising social protection for the development of high-quality, accessible and sustainable health care and long term care: Support of national strategies through the "Open Method of Coordination" Social Protection Committee Subgroup on Indicators - access - quality - sustainability Working Paper (December 2004): "A review of data for the Development of indicators for the OMC on health and long-term care" Proposed quality indicators: - Supply of staff - Supply of facilities - Supply of technology - Safety of medical treatments - Patient satisfaction and system responsiveness - Use of preventive care - Raising clinical effectiveness through evidence based medicine - training of health care professionals - patients rights and transparency

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 6 European Union - Who promotes quality indicators? EUROSTAT Proposal Regulation concerning Community statistics on public health and health and safety at work First level: framework act Second level: EC implementing measures Third level: methodological standards, manuals, guidelines EUROSTAT - Statistical Programme Committee Annexes to the proposal Anex I Health status and health determinants Annex II Health care including...“quality and other elements to assess accessibility, equity, satisfaction, efficiency, effectiveness and sustainability of health care“... Annex III Causes of death Annex IV Accidents at work Annex V Occupational diseases

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 7 The presentation will deal with  EU efforts to develop quality indicators  Austrian efforts to develop quality indicators  The patients perspective

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 8 § 4 Standards, Federal quality directives and guidelines §§ 8, 10 Controls, Sanctions § 9 Federal institute for quality in the health care system §§ 1, 2, 3 Objectives, Terminology, Scope of applicability § 6 Quality reports § 7 Promotional measures, Incentives § 5 Structure, Process, Outcome quality Components of the Austrian Health Care Quality Act

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 9 § 4 Standards, Federal quality directives and guidelines §§ 8, 10 Controls, Sanctions § 9 Federal institute for quality in the health care system §§ 1, 2, 3 Objectives, Terminology, Scope of applicability § 6 Quality reports § 7 Promotional measures, Incentives § 5 Structure, Process, Outcome quality Components of the Austrian Health Care Quality Act

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 10 First Austrian Quality Report – criteria for indicators  Use existing data and minimise collection procedures (which does not exclude work on "unexplored areas" in the future)  Describe the quality of the health system instead of purely clinical outcomes — structure, process, outcomes, access  Take into consideration (different) developments at international level  Reconcile (differing) opinions on quality indicators

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 11 Member States efforts to develop indicators CoEEUOECDWHO Definitions of data requirements Comparability Reporting mechanisms regions level community level health professionals patients Definitions of data requirements Comparability Reporting mechanisms

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 12 The presentation will deal with  EU efforts to develop quality indicators  Austrian efforts to develop quality indicators  The patients perspective

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 13 Patient orientation is defined as...  Enable citizens/patients to be informed partners who are capable to assume their roles as co-producers with regard to their health  Enable health professionals to perceive and support citizens/patients as co-producers /partners with regard to their health  Enable health organisations/health systems to organise their structures in a way to support citizens/patients as co- producers/partners with regard to their health

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 14 Conclusion on patient orientation...  PO is not always the main driving factor for the development of quality indicators  Some of the proposed indicators bear the potential to enhance PO  How to envolve patients more in the process of quality indicator development?  Transparency as a means of increased patients envolvement?  PO impact assessment of quality indicators?

6 October 2005 Ursula Fronaschütz Austrian Federal Ministry of Health and Women 15 Thank you for your attention