Quality indicators in health care systems: National Resources Focus on Results, Processes and Productivity

Abstract

Introduction. Measuring the quality of health care in a country is one of the essential features of health quality improvement systems.
The Aim of the Study. Studying the experience of countries with strong economies in monitoring and evaluating the quality of health care, comparing with domestic experience in this area.

Materials and methods. The results of a review of English-language sites with data on measuring clinical indicators in the UK, Canada and the USA and websites of the national healthcare system (Ministry of Health of Ukraine, Center for Medical Statistics of the Ministry of Health of Ukraine, State Expert Center of the Ministry of Health of Ukraine, National Health Service of Ukraine) are given.

Results and discussion. It was found that in all countries with the data analyzed in our work, the tasks of continuous improvement of the quality of health care are solved due to the connection with clinical recommendations, state support for the processes of measuring the health care quality, the provision of software for calculations and the transparency of the definition of indicators.

Since 2018, parallel processes have been going on in the domestic healthcare system: а) clinical quality indicators are approved as part of industry standards in healthcare; b) indicators demonstrating the volumes of medical care are collected and processed by the Center for Medical Statistics of the Ministry of Health of Ukraine, c) The National Health Service of Ukraine generates special indicators based on the data of providers and users of medical services, processes, analyzes and publishes anonymized open data in the Unified State Open Data Web Portal in the form of special dashboards; these indicators are partly relevant to clinical indicators of quality.

Сonclusions: Based on a comparison of the indicators used by different countries, the connection of quality indicators with evidence-based data, further steps of a systematic approach in the field of improving the quality of medical care are determined, since the main tool for monitoring and evaluating medical care are special indicators - quality indicators. These indicators are calculated retrospectively according to standardized methods defined at the national level, which contributes to the transparency and accountability of health care. At the same time, the connection with evidence and clinical guidelines, software, templates and calculation formulas, scope and limitations, etc. are clearly defined and easily accessible, the number and types of indicators vary from country to country. In healthcare institutions, indicators are calculated using information technology based on patient data, focusing on aspects of the quality of care such as effectiveness and productivity. A systematic improvement in the quality of health care in practice can be achieved due to the relevance of the indicators calculated in the electronic health system with the evidence-based provisions of national clinical recommendations and the requirements of industry standards in the field of healthcare.