Recent OECD Publication: International comparisons of the quality and outcomes of integrated care: Findings of the OECD pilot on stroke and chronic heart failure
OECD Health Working Paper No. 142, May 2022,
Eliana Barrenho, Philip Haywood, Candan Kendir and Niek Klazinga
Across OECD countries, two in three people aged over 65 years live with at least one chronic condition often requiring multiple interactions with different providers, making them more susceptible to poor and fragmented care. This has prompted calls for making health systems more people-centred, capable of delivering high-quality integrated care. Despite promising, mostly local-level, experiences, systems remain fragmented, focused on acute care and unsuitable to solve complex needs. Moreover, assessing and comparing the benefits of integrated care remains difficult given the lack of technically sound, policy-relevant indicators. This report presents the results of the first OECD pilot of a new generation of indicators to support international benchmarking of quality of integrated care. Lessons from the pilot call for further work on: (1) expanding work on indicator development; (2) performing policy analysis to understand cross-country variations on governance models and health financing; (3) upscaling data linkage; and (4) measuring care fragmentation.
The report provides five key messages:
1. When reviewing national best practices, countries collect a growing volume of data but the lack of systematic data linkage at patient level undermines the value of the data to inform performance measurement for integrated care.
2. The 2020-2021 OECD pilot data on Integrated Care covered 15 countries and developed a new generation of indicators on mortality, readmissions and prescribed medicines for post-discharge care in stroke and congestive heart failure using linked data at patient level over a six-year period.
3. The pilot showed data collection is feasible, but linkage remains a challenge – 15 countries submitted data on mortality and readmissions but only four countries (Czech Republic, Denmark, Finland and Sweden) provided post-discharge medicine prescription data.
4. Data analysis suggests that OECD average masks large cross-country variations in outcomes within one year after discharge while trend analysis within countries shows improvements in outcomes. More analysis with multiple indicators and increased data linkages are required to measure integrated care.
5. To improve the international comparability of future data collections the OECD will refine the indicators and integrate into routine data collections the indicators on mortality and readmissions for post-discharge care in ischaemic stroke and congestive heart failure.
IFIC welcomes this report as a valuable contribution to the ongoing discussion of how to best measure integrate care. We believe it will be a good summer read to our global network.
Please consult https://www.oecd.org/health/integrated-care.htm for more detailed information about ongoing OECD work on Integrated Care.