1. European Parliament, Brussels 8 June 2017
HEALTH SYSTEMS FOR THE FUTURE: Making EU health systems resilient and innovative
Improving the Performance for Primary and Integrated Care Niek Klazinga MD PhD
European Parliament, Brussels
8 June 2017

2. The building blocks of Health Systems.
Health Care Services are only one of the determinants of health
Health Systems support citizens in realizing their potential health
Channeling professionalization to get the workforce for the future
De-institutionalizing health care delivery
Optimizing use of knowledge and technologies
Governing towards value-based performance
11/10/15

3. Health System Performance Framework OECD.
11/10/15

4. health measurement has evolved …..
Deaths
Mortality and life-expectancy
data source: death registries
Diseases
Prevalence and incidence of diseases
medical/clinical perspective
data source: administrative & clinical data
Disability
How health system deals with disabilities
DALY, QALYs, SF36
data sources: registries and surveys
Wellbeing
Things that matter to patients, carers, families & populations
Wellbeing, function, pain,
Quality of Life
Generic (e.g. EQ-5d; SF-12; Picker) and disease specific (HOOS, Oxford….)
Validated, sensitive & objective tools
Not sure if you want this slide but it does neatly describe the ‘journey’ outcomes measurement…perhaps it could be deployed later?
If used, emphasise that there is real science and empirical rigour behind the development and validation of these instruments.
They reliably measure what they proclaim to measure [clinicians often criticise them as subjective and soft and unreliable]

5. Two Major Re-design Challenges
Strengthening Primary Care
Strengthening Integrated Care:
-link PHC-Hospital Care
- link PHC-LTC
-link PHC-Mental Health
-link PHC-Public Health
- link Medical Care – Social Care .
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6. Making PHC future proof.
New professionals/ task substitution
Organizational formats
Performance Management based of adequate information systems
Using (non)monetary incentives
Patients not as clients of services but co-workers
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7. Making Integrated Care Future proof.
From disease pathways towards complex adaptive systems responsive to a multimorbid population
Adequate IT systems for governance
Supportive incentives and governance systems
Towards Learning Health Systems focused on outcomes.
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8. .
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