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Regulating Quality and Safety of Health and Social Care International Experiences

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Regulating Quality and Safety of Health and Social Care International Experiences CHILDREN AND FAMILIES The RAND Corporation is a nonprofit institution that helps improve policy and EDUCATION AND THE ARTS decisionmaking through research and analysis. ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE This electronic document was made available from www.rand.org as a public INFRASTRUCTURE AND service of the RAND Corporation. TRANSPORTATION INTERNATIONAL AFFAIRS LAW AND BUSINESS NATIONAL SECURITY Skip all front matter: Jump to Page 16 POPULATION AND AGING PUBLIC SAFETY SCIENCE AND TECHNOLOGY Support RAND TERRORISM AND Browse Reports & Bookstore HOMELAND SECURITY Make a charitable contribution For More Information Visit RAND at www.rand.org Explore RAND Europe View document details Limited Electronic Distribution Rights This document and trademark(s) contained herein are protected by law as indicated in a notice appearing later in this work. This electronic representation of RAND intellectual property is provided for non-commercial use only. Unauthorized posting of RAND electronic documents to a non-RAND Web site is prohibited. RAND electronic documents are protected under copyright law. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use. For information on reprint and linking permissions, please see RAND Permissions. This report is part of the RAND Corporation research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity. EUROPE Regulating quality and safety of health and social care International experiences Daniel Schweppenstedde, Saba Hinrichs, Uzor C. Ogbu, Eric C. Schneider, Dionne S. Kringos, Niek S. Klazinga, Judith Healy, Lauri Vuorenkoski, Reinhard Busse, Benoit Guerin, Emma Pitchforth, Ellen Nolte EUROPE Regulating quality and safety of health and social care International experiences Daniel Schweppenstedde, Saba Hinrichs, Uzor C. Ogbu, Eric C. Schneider, Dionne S. Kringos, Niek S. Klazinga, Judith Healy, Lauri Vuorenkoski, Reinhard Busse, Benoit Guerin, Emma Pitchforth, Ellen Nolte Prepared for the Department of Health The research described in this document was prepared for the UK Department of Health (England) within the PRP project ‘An 'On-call' Facility for International Healthcare Comparisons’. RAND Europe is an independent, not-for-profit policy research organisation that aims to improve policy and decisionmaking for the public interest though research and analysis. RAND’s publications do not necessarily reflect the opinions of its research clients and sponsors. R® is a registered trademark © Copyright 2014 RAND Corporation Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial pur- poses. Unauthorized posting of RAND documents to a non-RAND website is prohibited. RAND documents are protected under copyright law. For informa- tion on reprint and linking permissions, please visit the RAND permissions page (www.rand.org/publications/permissions.html). RAND OFFICES SANTA MONICA, CA • WASHINGTON, DC PITTSBURGH, PA • NEW ORLEANS, LA • JACKSON, MS • BOSTON, MA DOHA, QA • CAMBRIDGE, UK • BRUSSELS, BE www.rand.org • www.rand.org/randeurope Preface This report is concerned with ‘standards of quality and safety’ within health and social care systems. Care standards are intended to support efforts in maintaining and improving the quality of care; they have been developed across countries, although the ways in which they are implemented and applied differs between nations. Taking a range of six countries, we review the regulatory mechanisms that have been implemented to ensure that essential standards of care are applied and are being adhered to, and consider the range of policy instruments used to encourage and ensure continuous quality improvement. We report on Australia, England, Finland, Germany, the Netherlands and the USA, with the information presented reflecting the regulatory systems as of 1 August 2013. The report is intended to inform policy thinking for the Department of Health and others in developing the regulation of safety and quality of health and social care in England. It 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. 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. This report has been peer-reviewed in accordance with RAND’s quality assurance standards. For more information about RAND Europe or this report, please contact: Dr Ellen Nolte RAND Europe Westbrook Centre Milton Road Cambridge CB4 1YG United Kingdom Email: [email protected] Tel: +44 (0)1223 273853 iii Contents Preface ........................................................................................................................ iii List of figures ............................................................................................................... xi List of tables ..............................................................................................................xiii Summary ................................................................................................................... xv Acknowledgements .................................................................................................... xix CHAPTER 1 Introduction ........................................................................................... 1 1.1 Background ....................................................................................................... 1 1.1.1 Aim of this report ................................................................................ 1 1.2 Methodology ..................................................................................................... 2 1.2.1 Selection of countries ........................................................................... 2 1.2.2 Data collection ..................................................................................... 2 1.3 About this report ............................................................................................... 3 CHAPTER 2 Overview of findings ............................................................................... 5 2.1 Context for standards of quality within health and social care systems ............... 6 2.2 Standards of quality and safety in health and social care ..................................... 9 2.3 Regulatory strategies and actors for assuring quality of care.............................. 12 2.3.1 Principal regulatory strategies and mechanisms for health and social care governance ........................................................................ 14 2.3.2 Main actors responsible for assuring standard adherence in health and social care ......................................................................... 16 2.4 Effectiveness of regulatory strategies and systems ............................................. 25 2.4.1 Case study: inspections ...................................................................... 27 2.5 Trends in regulatory approaches ...................................................................... 29 2.6 Summary ......................................................................................................... 31 CHAPTER 3 Australia ............................................................................................... 33 3.1 System overview .............................................................................................. 33 3.1.1 Organisation and financing of the health and social care systems ....... 33 3.1.2 Principles of healthcare governance .................................................... 34 3.1.3 Recent reforms of the health and social care systems .......................... 34 3.2 National framework for care quality ................................................................ 36 v Regulating quality and safety of health and social care RAND Europe 3.2.1 Sources of minimum standards of quality in the health and social care systems ........................................................................................ 36 3.2.2 Overview of main bodies responsible for standard setting and enforcement ....................................................................................... 39 3.3 National regulatory bodies ............................................................................... 40 3.3.1 Australian Commission on Safety and Quality in Health Care (ACSQHC) ....................................................................................... 40 3.3.2 National Health Performance Authority (NHPA)
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