Improve and measure the quality of health care


This publication presents new data on patient safety in OECD countries and shows that large variations in quality of care remain for cancer, stroke, heart attack and services provided by physicians in the OECD. family. The paper discusses ways in which countries can improve quality measurement, the balance between privacy and transparency in terms of quality and safety, and the links between quality indicators and policy to improve the performance of countries. doctors, hospitals and the health system as a whole.


Health care systems face increasing challenges: increasingly complex care, rising demand for health care (especially for chronic diseases) and an economic context where the supply of services must increase at lower cost. Measuring the quality of health care becomes a key issue. Poor quality of care undermines the goals of modern systems and harms the health status of the population and even increases mortality rates. In addition, this deficient quality wastes health care resources, an unacceptable situation at all times, but even more so when financial resources are scarce. The OECD Health Care Quality Indicators (HCQI) Project has been developing since 2002 a conceptual and methodological framework on the quality of care.

Analysis / results

It is becoming increasingly evident in many countries that health care is offered without consideration of scientific principles and good professional practice. The result is a lower quality of care and negative effects for tens of thousands of people. However, many countries are improving the quality of their health services, and this progress is largely based on measuring quality.

Measuring, evaluating and comparing quality of care are three essential elements of health system governance that seeks to improve quality. Ultimately, the goal is to provide safe, effective and responsive care for patients.

Quality indicators developed by the OECD HCQI Project show the variability in quality of care across OECD countries:

  • Available data for asthma, chronic obstructive pulmonary disease, diabetes and heart disease show the importance of an effective primary care system.
  • Data on heart attacks and strokes show a large overall improvement in the quality of care, but some countries still show very poor performance.
  • Hospital readmission data for schizophrenia and bipolar disorder cases, which vary widely across countries, raise questions about the quality of mental health care.
  • Data from patient safety indicators raises questions about reporting incidents (for example, accidental lacerations or trauma in obstetrics) and improving safety policy.

Survival and mortality data from cancer show improvements in care, but there is wide variation from one country to another.


This report describes why information about the quality of health care is important and how it can be used. It presents examples from several countries that illustrate how quality improvement initiatives can be implemented in various care systems. Despite these examples, there is still a lot of work to be done and improved care needs to be adapted to each context. However, the various experiences reported in several countries by the experts make it possible to draw similar conclusions.

Consequences, recommendations

Recommendations for Quality Measurement Indicators for Health Care

Access to Data:

  • develop a legislative framework that balances data protection and confidentiality with the need for valid and accessible information to support good governance;
  • exploit the potential of national databases and registers to measure the quality of care;
  • implement the use of computerized health records;
  • establish national systems for collecting longitudinal data on patient experience.

Recommendations for the application of health care quality indicators

  • Ensure that common indicators are used to account for all improvements in the quality of care.
  • Ensure consistency and alignment of quality measurement efforts with the national quality of care policy.
  • Look for examples of quality improvement in other countries’ practices and determine how they can be applied locally.

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