why focus on health outcomes a change in direction
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Why Focus on Health Outcomes? a change in direction Inputs - resources needed to carry out a process or provide a service Outputs – the direct result of the interaction of inputs and processes in the system; the types and quantities of goods and services produced by a service .

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why focus on health outcomes a change in direction
Why Focus on Health Outcomes? a change in direction

Inputs - resources needed to carry out a process or provide a service

Outputs – the direct result of the interaction of inputs and processes in the system; the types and quantities of goods and services produced by a service.

a forty one billion dollar question

slide2
The Measurement of Output and Productivity in the Health Care Sector in Canada: An Overview(Sharpe, Bradley and Messinger)

Conclusions:

  • Price indices for health care output may be overestimated
  • Better documentation of methodologies
  • Quality improvements are not captured
  • Not clear whether increased spending on health is due to higher prices or increasing quality and quantity
what are health outcomes
What are Health Outcomes?
  • A measure of the effectiveness of our health care system and of the impact of public policies that influence health
  • The effect on health status from performance (or non-performance) of one or more processes or activities carried out by healthcare providers. USAID health and workforce improvement project
  • Health outcomes are used to examine the rate of death or illness (eg, the number of lung cancer deaths per 100,000 people).North Dakota health indicator glossary
  • A health outcome is: A change in the health of an individual, or a group of people or a population that is wholly or partially attributable to a health intervention or a series of interventions.Australian government website
choose outcomes that count
Choose outcomes that count
  • WHO estimates 1/3 of all social and economic costs to society are due to chronic diseases caused by tobacco, alcohol, high BP, high Cholesterol ad obesity
  • 30% of Canadian have at least one of seven high impact chronic health conditions and 1/3 of these people have multiple chronic health conditions
health outcomes the players
Health Outcomes – the players
  • Public Policy Makers
  • Health Care System Managers
  • Health Care Providers
  • Individuals, families and communities
how do we provide care now
How do we provide care now?

Canadians with diabetes:

  • < 50% get all the recommended tests and procedures that experts recommend
  • > 50% have poor cardiovascular health
  • ~ 50% do not achieve recommended levels of blood sugar
effective health records
Effective health records

Australia Canada Germany Netherlands NZ UK US

quality care makes a difference
Quality Care makes a difference

*Quality – receives recommended tests and Rx over 5 yrs

how can we do it better
How can we do it better?

Move from find it, fix it to prevent it, find it, manage it

approaches to improving quality of care include effectively measuring outcomes
Approaches to improving quality of care include effectively measuring outcomes
  • Teams: Interprofessional teams and case management improve quality of care
  • Technology: Electronic health records, reminder and clinical-support information systems can improve quality of care and outcomes
  • Tools: Training and support to set and monitor goals improves quality of care
conclusions
Conclusions
  • Health care (not medical care) requires inter-sectoral cooperation as much as inter-provincial cooperation
  • Health care is a major contributor to the health of the economy and healthy communities are more viable
  • Health care with good outcomes is a contributor to society not a cost
  • We must have appropriate information systems to support health outcome assessment (Visa)
  • Concentrate on a few outcomes with the greatest impact
  • We need specific assessment of individuals within communities over time
slide16
Thank You

www.healthcouncilcanada.ca

oecd health status ranking
OECD Health Status Ranking

Adapted from We Can do Better – Improving the Health of the American People. Steven A Shroeder.

Shattuck Lecture, N Engl J Med 357;12 September 20, 2007

number of us deaths from behavioral causes 2000 mokdad et al
Number of US Deaths from Behavioral Causes, 2000 (Mokdad et al)

We Can do Better – Improving the Health of the American People. Steven A Shroeder.

Shattuck Lecture, N Engl J Med 357;12 September 20, 2007

slide20
Change the way we organize and deliver health care for people with chronic conditions
  • Provide better care for high-risk populations
  • Coordinate sustained action on prevention
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