1 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

2 Presentation Outline Purpose and basis for HCQI Project Recent progress Next Steps – Updating Data and Developing Indicators

3 Broad purpose of OECD’s 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

4 HCQI Foundation Analysis of available measures and consensus efforts The Nordic Council of Ministers 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

5 “Regular” annual Collection

6 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)

7 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?

8 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

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

10 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 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 OECD’s 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.

11 Contact information Dr. Peter Scherer Head; Health Division OECD Dr. Edward Kelley Head, Health Care Quality Indicators Project OECD Web site –OECD Health Care Quality Indicators –