OECD Health Care Quality Indicator Project Prague March 5th 2009 Sandra Garcia Armesto on behalf of the HCQI team

Current Streams of Work 1.Regular data collection Periodic update of a set of indicators suitable for international comparisons Ongoing methodological work to improve international comparability 2.New indicator development in priority areas: Mental Health Care Patient Safety Health Promotion, Prevention and Primary Care Responsiveness/Patient Experiences

HCQI Data Collection“Regular set” Care for acute conditions OutcomeProcess In-hospital AMI case-fatality ratesWaiting times for surgery after hip fracture Age 65+ In-hospital ischemic/hemorrhagic stroke case-fatality rates Cancer care OutcomeProcess 5 years-Survival rate for colorectal cancerMammography screening 5 years-Survival rate for breast cancerCervical cancer screening 5 years-Survival rate for cervical cancer Care for chronic conditions OutcomeProcess Hospital admission rate for asthma (people 18+)Annual retina exam for diabetics Asthma mortality rates (people aged 5-39) Prevention of communicable diseases OutcomeProcess Incidence of measlesVaccination against measles Incidence of PertussisVaccination against Pertussis (+ diphtheria and tetanus) Incidence of Hepatitis BVaccination against Hep. B Vaccination against influenza (people 65+) Other Smoking rates

HCQI Data Collection New Indicators Health Promotion, Prevention and Primary Care Indicators 23. Asthma admission rate 24. COPD admission rate 25. CHF admission rate 26. Angina without procedure admission rate 27. Diabetes short-term complications admission rate 28. Diabetes long-term complications admission rate 29. Uncontrolled diabetes admission rate 30. Diabetes lower extremity amputation rate 31. Hypertension admission rate Mental Health Care Indicators 32. Unplanned schizophrenia re-admission rate 33. Unplanned bipolar disorder re-admission rate Patient Safety Indicators 34. Foreign body left during procedure 35. Catheter-related bloodstream infections 36. Post-operative pulmonary embolism or deep vein thrombosis 37. Post-operative sepsis 38. Accidental puncture or laceration 39. Obstetric trauma vaginal delivery with instrument 40. Obstetric trauma vaginal delivery without instrument

Data Sources for Quality Indicators Mortality statistics Vaccination/Infection registries Cancer registries Disease specific registries Administrative Data-bases Population and Patient based surveys

OECD HD WP: N0.23 Health Care Quality Indicators Project Conceptual Framework Paper 2006Health Care Quality Indicators Project Conceptual Framework Paper No.22 Health Care Quality Indicators Project Initial Indicators Report 2006Health Care Quality Indicators Project Initial Indicators Report No.29 Health Care Quality Indicators Project data collection update report 2007 Health Care Quality Indicators Project data collection update report OECD HD TP: No. 20 Information Availability for Measuring and Comparing Quality of Mental Health Care Across OECD Countries 2008Information Availability for Measuring and Comparing Quality of Mental Health Care Across OECD Countries No. 19 Facilitating Cross-National Comparisons of Indicators for Patient Safety at the Health- System Level in the OECD Countries 2008Facilitating Cross-National Comparisons of Indicators for Patient Safety at the Health- System Level in the OECD Countries No. 18 Selecting Indicators for Patient Safety at the Health Systems Level in OECD Countries 2004Selecting Indicators for Patient Safety at the Health Systems Level in OECD Countries No. 17 Selecting Indicators for the Quality of Mental Health Care at the Health Systems Level in OECD Countries 2004Selecting Indicators for the Quality of Mental Health Care at the Health Systems Level in OECD Countries No. 16 Selecting Indicators for the Quality of Health Promotion, Prevention and Primary Care at the Health Systems Level in OECD Countries 2004Selecting Indicators for the Quality of Health Promotion, Prevention and Primary Care at the Health Systems Level in OECD Countries No. 15 Selecting Indicators for the Quality of Diabetes Care at the Health Systems Level in OECD Countries 2004Selecting Indicators for the Quality of Diabetes Care at the Health Systems Level in OECD Countries No. 14 Selecting Indicators for the Quality of Cardiac Care at the Health Systems Level in OECD Countries 2004Selecting Indicators for the Quality of Cardiac Care at the Health Systems Level in OECD Countries Relevant publications

Health at a Glance Released every two years November 2007: Main new feature was the new chapter on health care quality indicators November 2009: Health care quality chapter to be expanded to reflect recent indicator development.

Methodological Improvements agreed upon during the HCQI expert meeting October 2008 Transparency on the quality of data-sources –representativeness –completeness –regular update –stability of the data source –capability to track patients through the system Standardization by age and sex where relevant

Recommendations for Data and Information Systems Recording in administrative databases of conditions present at hospital admission More detailed recording in administrative databases of secondary diagnoses Enhance international comparability of procedures Implement the use of Unique Patient Identifiers in national data systems Establish national information systems for out-of-hospital care; notably in primary care and mental health care, with similar capacity to generate internationally comparable data as hospital administrative data systems

Work Plan 2009/10 Data collection 2008/2009 ongoing Extended Chapter in Health at a Glance 2009 Continuation work in subgroups on safety, primary care and responsiveness Start more analytical work to explore differences in performance and possible relations with the organization and financing of health care (cancer care, cardiovascular diseases)

Thank you!!!!