Robust health information systems are a cornerstone of high-performing health systems, enabling continuity of care, performance assessment and evidence‑informed policymaking. The OECD has emphasised that the ability to link data across care settings and to support their secondary use is essential for monitoring quality, improving outcomes and strengthening accountability (OECD, 2023[1]). Similarly, the WHO highlights that integrated, interoperable health information systems are critical to advancing universal health coverage and driving system improvement (WHO, 2021[2]).
Figure 5.1 shows countries’ ability to link patient-level data across care settings. Capacity varies widely across LAC countries. Costa Rica, Peru and Paraguay report near-comprehensive linkage across primary care, hospital, prescribing and mortality datasets, enabling tracking along the care pathway. By contrast, several other countries report only limited linkages, often restricted to hospital – mortality (Chile) or hospital – prescribing (Brazil) connections, reflecting more fragmented information systems.
Across the region, the most common linkages connect hospital data with mortality records and hospital data with prescribing data. In contrast, linkages involving primary care – particularly connections between primary care and prescribing or hospital data – are less consistently available. These gaps constrain the ability to assess continuity of care and long-term outcomes beyond the hospital setting and limit the production of accurate performance assessments that can effectively drive quality improvement.
Embedding secondary uses of health data within national legal and policy frameworks is another critical dimension of health data capacity. Figure 5.2 shows substantial cross-country variation in whether national plans, laws or strategies explicitly include secondary uses such as quality monitoring, system planning or research across different care settings. Some countries report broader formal recognition of secondary uses across multiple settings, while others indicate more limited or setting-specific provisions, often concentrated in hospital data. These differences reflect varying levels of policy development regarding the governance and strategic use of health data.
Regular use of health data for quality assessment and improvement remains uneven across the region. Eleven countries report routinely using hospital and nine countries mortality data to publish or monitor quality indicators, systematic reporting based on primary care, prescribing data, long term care or cancer registry is less common. In some cases, data may exist and even be linkable but are not yet routinely translated into publicly reported quality indicators. This suggests that data availability and linkage capacity do not automatically lead to systematic use for performance monitoring. Strengthening analytical capacity and institutional arrangements for health intelligence remains an important next step in many countries.
