ECHO

European Collaboration for Healthcare Optimization

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 Obiettivo del progetto (Objective)

'ECHO, European Collaboration for Healthcare Optimization, gathers the interests for Healthcare Performance Measurement of different Academic and Research Institutions from six European countries and an International Body for Healthcare Policy Analysis. Designed as a 48 months project, it has been conceived as a “pilot study” based on available administrative databases. It aims at describing the actual performance of six different Healthcare Systems at hospital, healthcare area, regional and country level. To tackle performance measurement in this project, two different methodological approaches will be used: [a] a population geographical-based, responding the question: Is the access to a diagnostic or surgical procedure dependant on the place where a person lives? And, [b] a provider-specific, answering the question: Is the risk for a patient to access high quality care -and have better health outcomes- different regarding the provider in which he or she is admitted? Utilization, equity in access and allocative efficiency will be analysed as performance measures in the former approach; and, healthcare outcomes and associated costs will be measures in the latter one. ECHO has been envisaged as a five work packages project. The first two work packages are devoted to prepare the core work package (WP#3) Performance Measurement and Report; so, the WP#1 is committed with the creation of the ECHO Data Warehouse and the second one is dedicated to the Methodological foundations of the project. Work packages #4 (web-based tools development) and #5 (dissemination) are carefully thought to ease the diffusion of our findings to decision-makers; in the former, a web-based analytical tool will allow advanced users to replicate methods and analysis; in the latter, local key agents like policy decision-makers and managers, will feed the findings making them transferable to their own decision-making process.'

Introduzione (Teaser)

ECHO is an EU-funded project aiming to assess variations in healthcare performance and provide evidence to inform policy decisions.

Descrizione progetto (Article)

As many of Europe's health care systems struggle to provide accessible, equitable and high-quality care while minimising related costs, key stakeholders need the appropriate information to make the right decisions. The 'European collaboration for healthcare optimization' (http://www.echo-health.eu/ (ECHO)) project is tackling this challenge with a view to deliver evidence on unwarranted variations in health care performance using a refined set of performance indicators.

The project has created a common data warehouse containing administrative data from five European countries and a series of online tools as part of a comprehensive knowledge system. The system allows users to explore equitable access, quality and safety, and efficiency of health care at hospital, health care area, regional and country levels.

ECHO has focused on developing a robust methodology to compare performance across healthcare systems, by homogenizing the information from 200 million discharges, building valid crosswalks across coding languages in up to 50 performance indicators, making patients and populations comparable and creating benchmarks to allow meaningful international comparison.

ECHO performance Atlases report unwarranted differences in health systems performance across ECHO countries on cardiovascular care, lower value care and potentially avoidable admissions have been yielded. These reports, available at the ECHO website, feature cross- and in-country variations in performance, its evolution over-time, the effect of socioeconomic gradient at population level, and provide some policy messages derived from the results.

To date, ECHO has shown that it is feasible to create a research infrastructure based on routinely patient-level data from different countries. The project has also illustrated that it is possible to make these data reliable and accurate across health systems.

The ECHO concept and methods have been recognized as meaningful by several international institutions, being one of the Health Systems Performance Assessment (HSPA) initiatives highlighted at the EC experts group on health systems performance assessment. ECHO has been advising several high-profile groups, including the OECD expert groups on variations in medical practice and on healthcare quality indicators. On the other hand, ECHO has the potential to improve access to quality health care across Europe.

A recently released special issue of the http://eurpub.oxfordjournals.org/content/25/suppl_1 (European Journal of Public Health), gathers a number of scientific papers reflecting the work done by ECHO.