The OECD Health Care Quality Framework

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The quality framework laid out in OECD Health Working Paper 23: HCQI Conceptual Framework Paper represents an exhaustive review and synthesis of the major health system frameworks in use in both OECD countries and international organisations such as WHO. It focuses the present work of the HCQI Project on the areas of effectiveness, patient safety and responsiveness while situating the project in the broader context of health systems performance.

Key Results of the HCQI Conceptual Framework Paper, OECD Health Working Paper 23

The HCQI quality framework should be multi-dimensional in nature and be based on operational experience by member countries with assessing health systems performance in general and quality of care in particular
On the question of what dimensions of quality to measure, the HCQI framework should rely on the most commonly used dimensions of quality in existing country and international organisation frameworks. These are:

o Effectiveness
o Safety
o Responsiveness/patient centeredness
o Access/accessibility
o Equity
o Efficiency

The project should currently focus on the issues of effectiveness, safety and responsiveness/patient centredness, while acknowledging other common dimensions.
On the question of how, in principle, quality should be measured, the HCQI quality indicator set should contain both process and outcome measures. Moreover, the indicator set should be based on three main criteria: i) the importance of what is being measured; ii) the scientific soundness of the measure; and iii) the feasibility/cost of obtaining data.