Work Package 5 Outpatient Care

1. Work Package 5 Outpatient Care John Hutton IQ Annual Meeting, Hanover February 2012

2. General Objectives • To identify and analyse the impact of payment mechanisms on the nature and quality of health care services delivered outside the hospital • To assess the impact of the quality of outpatient care on the ability of other sectors of health care systems to deliver efficiency and equity objectives

3. Approach • Use the definitions from WP2 and the typologies from WP1 to define the main payment options for outpatient care • Analysis of UK experience and international comparison to identify any common themes and recommendations, using the list of contextual factors from WP1

4. Main Activities • Literature review to identify measure of quality used in outpatient care and assess the results of evaluations of payment mechanisms in outpatient care • Detailed case study of UK primary care • Comparison with other systems – Poland, Denmark, Germany • Policy analysis of preferred characteristics of payment systems in outpatient care and the transferability of successes between systems

5. Collaborative Working • With WP1 to expand literature review of UK policies, especially QOF • With WP2 on indicators and measures • With WP4 on UK hospital system and links between hospital and outpatient care • With SDU and MHH on comparative study

6. Specific Activities

7. 5.1 Literature Review and Definition Development Objectives • To clarify the work of WP1 and WP 2 in relation to outpatient care and establish the analytical framework • Identify data sources • Contribute to collaborative working with WP1 and WP2

8. 5.1 Literature Review and Definition Development Methods • Supplementary literature review on UK • Collaborative working with WP1 and WP2 Deliverable • Descriptive report on relevant definitions of payment systems, quality measures and data sources Timing • Completion in May 2012

9. 5.2 Detailed Study of UK Primary Care Objectives • To document the successive changes in financing of UK primary care over the last 20 years • Identify evidence of impact on quality and efficiency • Detailed case study of QOF

10. 5.2 Detailed Study of UK Primary Care Methods • Literature review, expert consultation Deliverable • Report detailing quantitative and qualitative findings Timing • Completion in May 2012

11. 5.3 Comparative Study of Outpatient Care Payment Systems in 4 Countries Objectives • To identify differences and similarities between UK, Poland, Denmark and Germany • To examine the organisational, political and economic contexts in which each country developed its systems • To assess the transferability of payment systems

12. 5.3 Comparative Study of 4 Countries Methods • Collaborative working with SDU, MUW and MHH • Use definitions and typologies from WP1 and WP2 • Select specific group of outpatient services • UY to produce template for partners

13. 5.3 Comparative Study of 4 Countries Deliverable • Report on comparison of payment systems for specific outpatient care services in 4 countries Timing • Start March 2012 – Completion December 2012

14. 5.4 Mixed Systems of Financing for Outpatient Care Objectives • To identify preferred payment approaches for each element of outpatient care • To test feasibility of a generalised optimal financing model across countries • To identify implications for integrated care

15. 5.4 Mixed Systems for Financing Outpatient Care Methods • Synthesis of findings of 5.1, 5.2 and 5.3 • Collaborative working with WP6 and other partners Deliverable • Report on feasibility of generalised mixed system of financing for outpatient care across European countries Timing • Start November 2012 – Completion May 2013

16. Progress: Collaborative Working • WP1 – review of typologies and supplementary literature review of UK policy changes (Started) • WP2 – review of concepts and definitions on outcomes and equity (Started) • WP4 – comparative study of UK, Italy and Denmark (Started)

17. Progress: Main Tasks • 5.1 Initial literature searches undertaken • 5.2 Literature searches on QOF complete and co-operation of NICE with the project established

18. Thank you for your attention! InterQuality website: http://www.interqualityproject.eu/