Peter Scherer Head, Health Division OECD Patient Safety Seminar – “Safety Data for Safer Care”

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 • 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 The Nordic Council of Ministers

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 10-15 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 SchererHead; Health DivisionOECDpeter.scherer@oecd.org • Dr. Edward KelleyHead, Health Care Quality Indicators ProjectOECDedward.kelley@oecd.org+33-1-4524-9239 • Web site • OECD Health Care Quality Indicators – www.oecd.org/health