Data linkage key to better performance monitoring

National linkage of healthcare data is the key to better monitoring and reporting of international healthcare performance, OECD representative Dr Niek Klazinga told a HARC (Hospital Alliance for Research Collaboration) Forum this month.

In Sydney to address the latest HARC Forum and a HARC roundtable of key health decision makers, Dr Klazinga, who is head of the Health Care Quality Indicators Project in the OECD Health Division, said that although there was national record linkage in Australia, from an OECD perspective the linkage capability was low. National record linkage projects were not being used for regular healthcare quality monitoring, he said.

Having a unique patient identifier was useful but “if data collections don’t allow you to use that productively you get stuck”, he said.

Tapping into new outcomes measures

Data linkage was the key to having the capacity to tap into new health outcome measures, he said. However, he acknowledged that countries were struggling with this issue, with political debate over privacy being a major concern.

Similarly, e-health record systems and data collection in primacy care were areas for development.

“There are no countries that can derive the kinds of system-level indicators from e-health records,” he said. “And generally speaking there are no good representative data collections on the quality of primary care so we are working with potentially avoidable admissions as a proxy of how good the primary care systems are.”

Dr Klazinga outlined the OECD Agenda for Health Care Quality Indicators in 2015/16, saying his organisation would continue working on strengthening the information infrastructure in OECD countries. The OECD would also focus on the use of its quality indicators in national and regional health system performance reports, it would conduct an inventory of indicators used, compare reporting frameworks and conduct an overview of the ways of public reporting.

Shift in focus

The OECD had been working with outcome measures and quality indicators since 2002, and over time there had been an overall shift in focus from outcome data such as mortality and life expectancy, to the prevalence and cost of disease, to measuring the impact of disability, and finally to patient reported outcomes and levels of discomfort, Dr Klazinga said.

He said many countries were experiencing a slow recovery in healthcare spending after a major decline between 2008 and 2010 during the global financial crisis. Increasingly, countries were also developing national performance frameworks.

“Many countries are not just dealing with cost control, they are really trying to capture the outcomes of their systems. They are trying to produce outcomes that tell them where they are and where they are heading and having meaningful debate about the allocation of resources and delivery,” he said.

The forum also heard from National Health Performance Authority CEO Dr Diane Watson and Bureau of Health Information CEO Dr Jean-Frederic Levesque, who discussed performance monitoring in the local context.

Find out more

  • Learn about HARC, a collaboration between the Sax Institute, Agency for Clinical Innovation, Clinical Excellence Commission and the Bureau of Health Information
  • Visit our Multimedia room to view the HARC Five Questions video series