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The future of public health: policy decisions today for tomorrow’s populations. Our health, our economy, our society, our future: a Brave New World. Remarks by Yves Leterme, Deputy Secretary-General, OECD. Brussels, Belgium, September 4th 2013.
After falling sharply in 2010, health spending remained flat across OECD countries in 2011 as the economic crisis continued to have an impact, particularly in those European countries hardest hit by the crisis, according to OECD Health Data 2013.
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While the number of elderly people in need of care is projected to at least double, governments are struggling to deliver high-quality care to people facing reduced functional and cognitive capabilities. Based on a recent OECD and EC report, this policy brief looks at data and policies to measure quality in long-term care and drive standards of care up.
As ageing societies are pushing a growing number of frail old people into needing care, delivering quality long-term care services – care that is safe, effective, and responsive to needs – has become a priority for governments. Yet much still remains to be done to enhance evidence-based measurement and improvement of quality of long-term care services across EU and OECD countries. This book offers evidence and examples of useful experiences to help policy makers, providers and experts measure and improve the quality of long-term care services.
Health data constitutes a significant resource in most OECD countries that could be used to improve population health, the quality of health care and the performance of health systems. Rising levels of chronic diseases; concerns about the quality and safety of patient care; the need to assure value for investments in health care; and the need to allocate health resources wisely; are all too important to be left without good evidence for decision making.
This book, based on studies of 19 countries on the development and use of personal health data and of 25 countries on development and use of electronic health record systems, includes results showing good practices, new opportunities and data privacy protection challenges. It finds that well-intended policies to allay concerns about breaches of confidentiality and potential misuse of personal health data may be limiting data use, but that the next five years appear promising, in terms of both the number of countries that plan to implement national electronic health record systems and the number that consider it likely that data from these systems will be used for some aspects of health care quality monitoring. They also appear promising for the further use of existing personal health databases and for the linkage of multiple data sources to generate new evidence.
This review of health care quality in Denmark examines policies related to quality and includes chapters covering primary and integrated care, hospital specialisation and equity. It finds that with a dense array of disease- and service-focused quality initiatives, and with information on the quality of care stored in separate data repositories, Denmark needs to create effective links and synergies between them to drive up quality in the healthcare system as a whole, rather than in disconnected elements.
Primary care will be central in meeting Denmark’s future healthcare challenges of an ageing population with multiple chronic conditions. Therefore, an urgent need is to create a national vision of how a modernised primary care sector will fulfill this new coordination role. National standards, clinical guidelines, accreditation of clinical pathways and targeted financial incentive programmes could support this role, along with more transparent and formalised continual professional development.
To facilitate quality improvement from the ambitious hospital rationalisation, Denmark should collect and disseminate data on the quality of individual physicians as well as the hospitals. Undergraduate training and medical research should be reviewed in light of the new service arrangements. Close surveillance will be needed to monitor whether certain patient groups forego healthcare because travel times to providers are too long. Limited data availability complicate Denmark’s ability to monitor its commitment to equitable healthcare. There is an urgent need for renewed action to tackle risk factors of chronic ill-health that disproportionately affect low-income groups. Better information on the impact of user-charges on unmet need in low-income groups is needed.
The Danish central government and regions are leading international efforts to reform hospital systems, improving quality and safety by gathering specialists into major hospitals and closing smaller ones.
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Hospital Volumes: An International Perspective on Germany. Presentation by Mark Pearson during the BMG-OECD Conference on Managing Hospital Volumes, Berlin, April 2013.
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This Brief looks at the upcoming publication "Strengthening Health Information Infrastructure For Health Care Quality Governance" and argues that privacy-respectful uses of data for health, health care quality and health system performance monitoring and research must become widespread, regular activities.
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This report is about the progress that has been made in OECD countries to develop national health information infrastructure. It signals important differences among countries in both the data that is available and its accessibility and use; and the opportunities that exist in all countries to continue to strengthen health information infrastructure in the future.