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DATA AVAILABILITY AND COLLECTION IN
EUROPEAN HEALTHCARE
Dr. Arne Björnberg
05.03.2009
Prague
WHAT PERFORMANCE AND QUALITY INDICATORS
SHOULD BE MEASURED?
Data, which healthcare professionals have to
gather anyway to do their job:
input for patient records
prescription data
administrative data required for clinic
remuneration
…
Imposing any "extracurricular" data gathering
is doomed!
Patients' key areas of interest: outcomes and
accessibility!
PUBLIC ENEMY #1 FOR PERFORMANCE AND QUALITY
MEASUREMENTS
Global grant budgeting!!!
Healthcare providers, financed for what they do
and how well they do it, have a strong inherent
drive to monitor and report.
U.S. healthcare, for all its equity problems, is a
service INDUSTRY; performance and quality
measurement lightyears ahead of Europe.
EHCI CHARACTERISTICS
Overall picture of healthcare systems seen from the
customer/patient’s point of view (hard and soft data)
 Concentrates on indicators reflecting properties and
performance of healthcare systems

stays away from public health indicators!
 stays away from indicators closely correlated with GDP/capita

EURO HEALTH CONSUMER INDEX 2008
All 27 EU member states + Switzerland & Norway +
candidate countries Croatia and FYR Macedonia =
31 countries
34 indicators in six sub-disciplines;
1054 scores in the EHCI matrix
SOURCES:
"ANY SOURCE THAT CAN PROVIDE REASONABLY SOLID DATA"
"Objective hard facts": WHO, OECD or other statistics, decided policies,
regulations, legislation
Soft data: interviews, patient surveys
Survey to Patient Organisations regarding waiting times and 5 other
indicators commissioned from Patient View: 539 organisations
responded in 2008
6
Indata not symmetric for all countries - multiple data
sources on the same indicator frequently used.
SOURCES (2):
THE CONCEPT OF "CUTS"
On any indicator where data could be found from one single source
based on a well-defined methodology such as WHO databases, OECD
Health data, Special Eurobarometers, or scientific papers, CUTS data
was used.
European healthcare suffers from an extreme CUTS shortage!
7
CUTS: "Comprehensive Uniform Trustworthy Source"
VERIFICATION
Extensive work to establish national contacts with cardiac
societies, Ministries of Health, National Health Boards, etc.
MoH's / National Health Agencies are given the opportunity to
validate/update their national data and scores by receiving "Single
Country Score Sheets"
SCORING SYSTEM
Country scores in three grades under each indicator:
3 (green): good ( )
2 (amber): intermediate ( )
1 (red): not-so-good ( ); "n.a." = 1
Total score:
Max score:
1000
Minimum score: 333
calculated as % of maximum score under each sub-discipline many indicators in one area does not give added weight!
INDICATORS THAT WE WOULD HAVE LIKED TO INCLUDE
(BUT HAD TO OMIT DUE TO LACK OF DATA)
Patient Safety: Reported adverse events per 1000
admissions
Community Care: Hospital admissions per 1000
people >75 years of age (high = BAD!)