OECD REVIEWS OF QUALITY OF HEALTH CARE

RAISING STANDARDS: THE NORDIC COUNTRIES

Ian Forde

Health Policy Analyst OECD Health DivisionMay 2014

Where are the Nordic countries today?

Good outcomes, especially for hospital care

Health systems are generously funded

Health expenditure per capita, 2011 (or nearest year)

High levels of public expenditure on LTC

EMERGING CHALLENGES

Primary care is strong

Primary and community care is being asked to do more and demonstrate better value for money…

… but often ‘flying blind’

Increasing pressure on community services

Co-ordinated and integrated care is much discussed …

… but yet to deliver much benefit for patients and their families

A distinctive policy choice to take LTC outside of institutions

Private providers are increasingly important players in the market place of care…

… but getting the right balance between freedom and regulation remains unclear

Strong local governance is characteristic

Central authorities playing an increasingly prominent role in quality monitoring and improvement…

… but this can create tensions and inefficiencies

Contact: ian.forde@oecd.org

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Thank you

WHAT THE NORDIC COUNTRIES COULD DO…

Nordic countries need to ensure that

•there is a clear strategic vision for primary care shared by national government, county councils, municipalities and leaders in primary care •the reforms on choice and competition promote co-ordinated care and avoid fragmentation •payment and incentive systems foster co-operation, co-ordination and joint working.

Improving the quality of primary care

Encourage GPs to adopt a leading role in assuring quality and outcomes

Coordination

GovernanceInformation

Some examples…

• define a set of core quality standards for primary care that can be used to consistently and transparently monitor, assure and improve the quality of care

• study the effects of recent choice and competition reforms to ensure that they do not fragment services for patients with complex needs

• equip the primary care workforce to play a more proactive role in primary and secondary prevention of chronic disease

• standardise the information infrastructure in primary care to support improvements in the measurability of quality in primary care on a consistent basis.

Continuous quality improvement in long-term care

TO CONCLUDE…

Key policy recommendations

1. Develop richer information systems,

2. Clarify the role of central government,

3. Strengthen co-ordination and integration across services

4. Evaluate closely the effects of recent reforms

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www.oecd.org/health/qualityreviews