Methods of assessing response to quality improvement strategies (2005-2008)
The MARQuIS project provided a comparative analysis on the impact of different quality management strategies in European hospitals. The results of the project are guiding the development of quality improvement strategies in order to improve patient care, and adding to the evidence base on the effectiveness of quality management systems. The project involved 389 hospitals in eight countries and included an audit via on-site visits to 89 of them.
The project found clear differences in the extent to which EU Member States have formalised legislation and statutory requirements, and have implemented strategies to improve the quality of care. Some Member States have substantial experience in this field, whereas others are just getting started. Hospitals with a well-developed quality improvement system can be found in all Member States, and there is as much variation in the uptake of quality improvement strategies within countries as there is between countries. Future action in this field should make use of the existing research on quality and safety strategies in healthcare, and should aim to combine soft measures to accelerate mutual learning, and consider concrete measures only in areas for which a substantial evidence base exists, and effective implementation is likely.
The findings of this project have been published in the Journal Quality and Safety in Health Care (Qual. Saf. Health Care, Feb 2009; 18: i3 - i74).
The project involves 8 partners from the following countries: Spain, United Kingdom, Netherlands, Italy, Ireland, Belgium, Poland
EC contribution: 1.4 million
Health benefits and service costs in Europe (2004-2007)
For rational decision-making, national and EU policy-makers need reliable comparisons about available health services, how these are defined, what their costs are and which prices they will have to pay for them.
The HealthBASKET project has provided the first in-depth analysis of the benefit baskets and the benefit catalogues in nine European countries, representing a heterogeneous mix of health care systems. The country studies have shown that information on this issue is often difficult to access, since it is highly fragmented and non-systematic. The methodology developed in this study can gather heterogeneous information in a highly comparative manner and could be applied to explore and describe the health baskets and catalogues in other European (as well as non-European) countries.
Overall, while differences in average costs were significant between countries, within-country variation was also unexpectedly large in some cases, larger than between-country variation. These differences are partly due to different accountancy standards, but also due to prices per input unit and, most importantly, due to large and apparently real differences in practice (and therefore differences in actual coverage of services). Other explaining factors include data recording, cost-shifting to patients, exchange rates, demarcation of service to other sectors etc. Main findings and recommendations were published in the final report available in six languages and in the European Journal of Health Economics (open access: Eur J Health Econ 2005 [Suppl 1] 6:272)
The project involves 9 partners from the following countries: Germany, Italy, United Kingdom, Denmark, The Netherlands, France, Poland, Hungary, Spain
EC contribution: 1.5 million
HTA-methodology for innovative healthcare technologies (2007-2008)
High expectations are related to innovations in the healthcare sector with respect to improving the treatment of diseases, saving healthcare expenditures and generating employment. Particularly the large chronic diseases need more target-group specific, innovative interventions. The benefits of health technology assessment (HTA) to improve the evidence-base for medical treatment are generally accepted. However, the potentials of HTA are not fully exploited yet. In classical HTA, which is focussed on health outcomes and economic performance of therapies, the innovation component is nearly totally missing. Thus, advances in medical technologies in their early states are not sufficiently utilized.
This project aimed to close the gap between the development of new technologies and their application. An internationally agreed set of indicators for the assessment of health innovations has been developed, which can generically be used to analyse new technologies in an early stage. It expands the focus of HTA to include aspects of the technology as such, its scientific foundation, potentials, implementation and effects on society as well as implications of adoption or non-adoption. The set of indicators will support the use of HTA in a field of novel therapies where classical HTA is not applicable. It will provide the relevant stakeholder groups with structured information for their decision-making about the impact of emerging healthcare technologies.
The project involves 7 partners from the following countries: Germany, United Kingdom, Austria, Denmark, Latvia
EC contribution: 0.4 million