Demand-based services to optimise patient outcomes
Project members of 'Operations management and demand-based approaches to healthcare outcomes and cost-benefits research' (MANAGED OUTCOMES)(opens in new window) compared regional service delivery systems' performance in six European countries for four diseases — type 2 diabetes, stroke, hip osteoarthritis and dementia. These diseases represent different large-volume health service demands, and factors such as scope of services, care quality, response time and accessibility to health care services were considered. Comprehensive data were collected from case studies on these four large patient groups for case-specific, general and methodology-based comparison and analysis. Diverse health care systems' performances were reviewed in the selected EU countries using case instance reports and user experience surveys. Scenario analysis was facilitated by participatory futures workshops as well as operational and financial modelling of health care services. Project members successfully developed multi-perspective operational models to assess regional health service delivery systems and also performed comparative analyses of health care practices across Europe. Information systems were deemed essential for optimal integration and coordination of 'whole system' health care services, both within and outside the organisation. Whole system implies holistic disease treatment to optimise care instead of individual services for each symptom in diseases like diabetes. Diabetics have symptoms ranging from poor sugar control to kidney and eye problems with degree of severity depending on stage of disease. Early diagnosis and treatment of diabetes will prevent faster disease progression to more severe stages that require costlier health care resources. Low-cost processes could be designed by dividing such patients into demand segments based on disease progression for optimal resource allocation and better patient outcomes. Data analysis revealed that elective procedures similar to total hip arthroplasties would have better outcomes in high-volume specialised centres rather than multi-specialty hospitals. In the case of stroke patients, there were large variations identified in the organisation of services in different regions. Progress towards widely accepted care guidelines is still uneven across Europe and this seems to contribute to variation in health outcomes. Dementia diagnoses tend to be poorly recorded in information systems in all regions, and many different service providers are involved. MANAGED OUTCOMES project identified large differences in the organisation of dementia care services in various European regions and effects of community involvement and early diagnosis. Project outcomes were disseminated on the project website, and through reports, webcasts and journals. Members have created reports that provide comprehensive guidelines to empower stakeholders and policymakers in order to improve patient outcomes cost effectively and efficiently.
