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How health systems make available information on service providers Experience in seven countries Mirella Cacace, Stefanie Ettelt, Laura Brereton, Janice Pedersen, Ellen Nolte Prepared for the Department of Health within the PRP project “An ‘On-call’ Facility for International Healthcare Comparisons” EUROPE The research described in this report was prepared for the Department of Health within the PRP project "An 'On-call' Facility for International Healthcare Comparisons". The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. RAND’s publications do not necessarily reflect the opinions of its research clients and sponsors. R® is a registered trademark. © Copyright 2011 by RAND and London School of Hygiene and Tropical Medicine All rights reserved. No part of this book may be reproduced in any form by any electronic or mechanical means (including photocopying, recording, or information storage and retrieval) without permission in writing from the copyright holders. Published 2011 by the RAND Corporation 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 1200 South Hayes Street, Arlington, VA 22202-5050 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213-2665 Westbrook Centre, Milton Road, Cambridge CB4 1YG, United Kingdom RAND URL: http://www.rand.org RAND Europe URL: http://www.rand.org/randeurope To order RAND documents or to obtain additional information, contact Distribution Services: Telephone: (310) 451-7002; Fax: (310) 451-6915; Email: [email protected] Preface This report reviews information systems that report on the quality or performance of providers of healthcare in seven countries to inform the use and further development of quality information systems in the English NHS. The report was prepared as part of the project ‘An “On-call” Facility for International Healthcare Comparisons’ funded by the Department of Health in England through its Policy Research Programme (grant no. 0510002). The project comprises a programme of work on international healthcare comparisons that provides intelligence on new developments in other countries, involving a network of experts in a range of countries in the Organisation for Economic Co-operation and Development (OECD) to inform health (care) policy development in England. It is conducted by RAND Europe, in conjunction with the London School of Hygiene & Tropical Medicine. For more information on the project please see www.international- comparisons.org.uk. RAND Europe is an independent not-for-profit policy research organisation that aims to improve policy and decision-making in the public interest, through rigorous research and analysis. RAND Europe’s clients include European governments, institutions, NGOs and firms with a need for rigorous, independent, multidisciplinary analysis. The London School of Hygiene & Tropical Medicine is Britain’s national school of public health and a leading postgraduate institution worldwide for research and postgraduate education in global health. This report is being peer-reviewed in accordance with RAND’s quality assurance standards. For more information about RAND Europe or this report, please contact: Dr Ellen Nolte Director, Health and Healthcare RAND Europe Westbrook Centre Milton Road Cambridge CB4 1YG United Kingdom Email: [email protected] Tel: +44 (0)1223 273853 iii iv Contents Preface......................................................................................................................... iii List of tables ................................................................................................................ ix List of boxes ................................................................................................................ xi Executive summary ................................................................................................... xiii Acknowledgements .................................................................................................... xvi CHAPTER 1 Introduction .................................................................................... 1 1.1 Background........................................................................................................ 1 1.2 Public reporting and quality improvement ......................................................... 2 1.3 Methodology ..................................................................................................... 3 1.3.1 Conceptualising ‘quality information systems’ ...................................... 3 1.3.2 Selection of countries ............................................................................ 4 1.3.3 Data collection ..................................................................................... 5 1.4 This report ......................................................................................................... 5 CHAPTER 2 Overview of findings ........................................................................ 6 2.1 Institutional and policy context of quality information systems .......................... 6 2.2 Quality information systems available to patients ............................................... 8 2.3 Quality information aimed at commissioners, regulators and healthcare providers .......................................................................................................... 11 2.4 Data and indicators used by quality information systems ................................. 14 2.5 Evidence of the use of quality information systems ........................................... 19 2.6 Impact of information systems on provider quality ........................................... 21 2.7 Considerations for the design of quality information systems ........................... 21 CHAPTER 3 Denmark ........................................................................................ 23 3.1 The Danish healthcare system .......................................................................... 23 3.2 Quality information systems available to patients ............................................. 24 3.2.1 Choosing a general practitioner ............................................................. 24 3.2.2 Sygehusvalg.dk ..................................................................................... 25 3.2.3 Ventetider............................................................................................ 25 3.2.4 Sundhedskvalitet .................................................................................. 26 3.2.5 Det Nationale Indikatorprojekt ............................................................ 27 v International Healthcare Comparisons RAND Europe 3.3 Quality information aimed at commissioners, regulators and healthcare providers ......................................................................................................... 29 3.3.1 Tilsynslisten ........................................................................................ 29 3.3.2 Kliniske Kvalitetsdatabaser .................................................................. 30 3.3.3 Other sources of information ............................................................. 30 3.4 Evaluation of information systems ................................................................... 31 CHAPTER 4 England ......................................................................................... 32 4.1 The English healthcare system ......................................................................... 32 4.2 Quality information systems available to patients ...........................................
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