Health systems know very little about whether the health care delivered seeks to improve people’s well-being and their ability to play an active role in society. The success of health care is typically measured by survival rates after treatment or mortality or hospital utilisation. Often, though, differences between the best and worst performing hospitals are small. It is only when we measure outcomes reported by patients themselves – such as quality of life – that important differences in the outcomes of care emerge.
We need to better understand what patients themselves think of health care and whether it improves the outcomes that matter to them:
- The OECD benchmarks some aspects of patient experience in 19 countries, in ambulatory care… but we need to expand this survey to other care settings (such as in-patient and mental health care facilities), and to more countries
- Patient-reported outcome measures are in use for some conditions, such as hip and knee surgery… but different measures in different countries make international comparisons difficult
- And the biggest users of health care – people with multiple, long-term conditions – are not being asked at all
The Patient-Reported Indicators Survey (PaRIS) initiative addresses these critical information gaps and aims to develop international benchmarks of health system performance as reported by patients themselves.
KEY PRINCIPLES OF PARIS
The initiative includes:
- In areas where patient-reported indicators already exist, the OECD supports countries to accelerate the adoption and reporting of validated, standardised, internationally-comparable patient-reported indicators. The working party on Health Care Quality Indicators and Outcomes (HCQO) is the main body coordinating this work and three international working groups have started in early 2018 to discuss instruments, definitions and data collection strategies in three areas: hip and knee replacements, breast cancer care, and mental health care.
- A new set of internationally comparable measures will be developed to help policy makers assess to what extent their policies are on track to make health systems more people-centred. This new international survey focuses on patients with one or more chronic conditions, who are living in the community and who are largely treated in primary care or other ambulatory care settings. The PaRIS survey will provide policy makers with information to evaluate their relative performance in delivering people-centred care and in meeting the needs of this growing group of patients for which very few indicators are currently systematically collected.
Swedish data rough estimates from graphs; Source: National quality report for the year of diagnosis 2012 from the National Prostate Cancer Register (NPCR)
Sweden, Martini Klinik, BARMER GEK Report Krankenhaus 2012, Patient-reported outcomes (EORTC-PSM), 1 year after treatment, 2010.
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