INTERQUALITY

International Research on Quality in Healthcare

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 Obiettivo del progetto (Objective)

'International Research Project on Financing Quality in Healthcare InterQuality gathers the interest for financing systems' effect on quality of healthcare of researchers from seven EU countries and US. The study, based on administrative and survey data, is designed for 36 months. It will take into account needs of four different patient groups (sectors), affected by: hospital, outpatient, pharmaceutical and integrated care. The scope of research will cover: utilization of resources and efficiency, quality of care, including: equity of access, patient satisfaction and safety of treatment. Resources allocated by each sector will be analyzed in relation to risk of their overuse, underuse or misuse. Critical appraisal of individual contracts will be based on the New Institutional Economics theory. Principal-Agent framework, the new standard approach to modelling relationships between payers and providers in healthcare, will be applied to the analysis of reimbursement schemes. The first two work-packages will prepare theoretical background and collect statistical data in required format. Dedicated Data Warehouse will be launched and exploited by all project participants. Work-packages 3-6 will perform core analytical work by building and testing sector-specific models and delivering expected project results. The research will be conducted in Poland, Italy, Denmark, Germany, United Kingdom and United States. Each of the chosen countries has different health care financing system therefore the comparison of the results and outcomes, addressing different aspects of financial incentives' effect on quality of care, will advance the knowledge base on sustainability of the health systems. Further knowledge gained from the project will provide support for Member States to choose the right financing mechanisms in the different areas of the health care system, according to their needs, in order to achieve better health with available resources.'

Introduzione (Teaser)

The sustainability of European health care systems is under threat due to issues with cost, quality and coverage. Europe is looking for solutions to alleviate the socioeconomic and financial pressures resulting from rising public health needs.

Descrizione progetto (Article)

Current health care systems are mostly old fashioned and focus on the more expensive acute care. Proactive systems that provide effective primary care and implement preventive measures will keep patients healthier and reduce health care burden.

To change the status quo, the EU-funded 'International research on quality in healthcare' (http://www.interqualityproject.eu/ (INTERQUALITY)) project investigated the feasibility of adopting hybrid health care systems and financing models that have worked in the United States. This should help in optimal allocation of limited resources to raise the quality of health care while reducing costs.

Researchers comprehensively analysed the impact of financial incentives and financing methods on care quality, costs and patient outcomes. This revealed that provider behaviour is dependent on multiple factors rather than payment method alone and the institutional framework model as a whole is more important.

Optimising health care requires an integrated approach. This involves coordinating health care delivery processes such as disease management programmes with appropriate incentive schemes. Take, for example, the pay-for-performance (P4P) incentive where predefined quality measures determine performance. Reviews revealed that P4P programmes developed by both payers and physicians should effectively improve care quality.

Although pharmacy benefit management tools in the United States are effective, implementing similar tools in EU Member States requires a comparable institutional framework. Denmark's progressive drugs reimbursement system was found to be more equitable than those in other countries under study. However, substantial investments in software and information technology infrastructure are required. A central reimbursement register, an online adjudication of pharmacy claims system and e-prescribing would at least need to be established.

INTERQUALITY has successfully consolidated relevant information to provide a good reference on financing systems, outpatient care and reimbursement systems. This list of recommendations could help governments and public authorities make evidence-based decisions to cost-effectively deliver patient-oriented health care systems.