Improving access to health care data
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' (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 European Journal of Public Health, gathers a number of scientific papers reflecting the work done by ECHO.
Keywords
Health care data, performance indicators, data warehouse, knowledge system
