25 September 2018

More effective, patient-centred, and sustainable health systems: the benefits of health outcomes measurement

By Mary Baker and John Bowis

In the past ten years, the term ‘value’ has become central to debates on health systems reform. Ageing populations, an increasing burden of chronic disease, changing expectations of what health systems should deliver, and constrained public budgets, have all called into question the sustainability of health spending, and put the focus on the need to ensure value for money.

The Value of Health: Improving Outcomes multi-stakeholder initiative began in 2014 with the aim of providing a European level, health community response to debates on health system sustainability and reform. The initiative brought together a broad section of the health community – patients, medical professionals, public health experts, academics, and industry – in dialogue with each other, and with policy makers. Today we launch the final report of this four-year initiative.

The first aim of the report is to provide a multi-stakeholder perspective on how we should think about value at the level of the health system. We argue that health outcomes must be at the centre of any value definition; after all, improving the health of patients and the population is the fundamental purpose of all health spending.

At the same time, we highlight an array of other objectives, and potential benefits, which underpin and drive public health expenditure, and which must be included in a comprehensive analysis of value for money. These include: access to care, patient-centredness, health equity, health workforce sustainability, outcomes for carers, and the economic and social benefits of good population health.

If health outcomes are at the heart of our value definition, it is essential that we measure them. But we need to make sure that we measure the right things, and that includes measuring the outcomes that matter most to the users of the health system. Patient-reported outcome measures have a key role to play here – providing the patient perspective on the impact of treatment and care on outcomes such as pain, mobility, psychological well-being, and ability to carry out normal day-to-day activities.

If we measure health outcomes, we can use the data in a range of ways to learn and improve. The report outlines these possibilities in some detail, with examples drawn from across Europe. For example, we can use the data to: identify and learn from variation in health outcomes, and address instances of sub-optimal care; support continuous improvement initiatives, with patient involvement, at the clinical level; monitor performance and promote health system transparency and accountability; and support the implementation of new, integrated models of care.

The report also makes three recommendations which should inform the future work of the European Union on health systems:

  1. Continue to invest in the OECD’s Patient-Reported Indicators Survey (PaRIS) and broaden the work to encompass more health conditions;
  2. Integrate more health outcomes data into analyses of health system performance at EU level (such as the European Semester and the State of Health in the EU cycle);
  3. Support the development of health information infrastructure (such as electronic health records), which can enable standardised data collection and reporting

More broadly, we hope that the work of the initiative will inform future European level discussions on health systems reform, and provide an example of how the health community can work together in response to common challenges.

Click here to read the report

The Value of Health: Improving outcomes multi-stakeholder report was enabled by sponsorship from the European Federation of Pharmaceutical Industries and Associations and a number of its member organisations, and MedTech Europe.