PATIENT EXPERIENCES OECD HCQI Expert meeting 17 th of May, 2013 Rie Fujisawa
Patient experience indicators Consultation skipped due to difficulties in travelling Consultation skipped due to costs Medical tests, treatment or follow-up skipped due to costs Prescribed medicine skipped due to costs Waiting time of more than 4 weeks for getting an appointment with a specialist Waiting time of more than 1 hour on the day of consultation with a doctor (Regular) doctor spending enough time with patient during the consultation (Regular) doctor providing easy-to-understand explanations (Regular) doctor giving opportunity to ask questions or raise concerns (Regular) doctor involving patient in decisions about care and treatment 2
Data submission FRA, NLD, NZL, NOR and GBR used 2010 CWF International Health Policy Survey data. LUX used data collected through OECD-proposed questionnaire. AUT, CAN, ISR, JPN and ESP provided data collected through national surveys. Data are not available in BEL, CHL, FIN, GRC, IRL, ITA, KOR, POL, PRT, SVK, SVN and TUR. Validating data for ISR. Waiting for data from AUS, CZE (feasibility of using pilot data) and HUN. No news from DNK, EST and MEX. 3
International reporting The Secretariat used CWF data and raw data from pilot collection to derive values for PE indicators for AUS, CAN, FRA, DEU, LUX, NLD, NZL, NOR, SWE, CHE, GBR and USA. The Secretariat proposes to use this data source to report patient experiences for the first time in the publication. CWF data have been used in OECD Health at a Glance and accepted as appropriate data source for international comparison Patient experiences is an important domain of quality of care even though it is not often acknowledged and The subgroup has worked over the past years to develop these important indicators. 4
Proposals for HAG 2013 Unmet care needs Patient experiences 5
Unmet care needs: Consultation skipped due to difficulties in travelling, 2010 (preliminary) 17.5% 13.2% 10.3% 6.8% 6.5% 5.9% 5.7% 5.6% 4.4% 2.4% 1.9% 23.8% Total Female Male 0% 5% 10% 15% 20% 25% 30% Age-sex standardised rates (%) Source: Data on are from 2011 national survey based on OECD pilot questionnaire and data for other countries come from the Commonwealth Fund's International Health Policy Survey 2010. 6
Unmet care needs: Consultation skipped due to costs, 2010 (preliminary) Iceland 17.5% 13.2% 10.3% 6.7% 6.0% 5.7% 5.6% 4.4% 4.4% 2.4% 1.9% 24.1% 26.9% Total Female Male 0% 5% 10% 15% 20% 25% 30% 35% Age-sex standardised rates (%) Notes: The lowest age group for Iceland refer to 20-24. Source: Data on are from 2011 national survey based on OECD pilot questionnaire while data on Iceland come from Health and Wellbeing of Icelanders, follow-up survey 2009, and data for other countries come from the Commonwealth Fund's International Health Policy Survey 2010. 7
Unmet care needs: Consultation skipped due to costs by age group, 2010 (preliminary) Iceland 65+ 45-64 24-44 18-24 0% 10% 20% 30% 40% 50% 60% Notes: The lowest age group for Iceland refer to 20-24. Source: Data on are from 2011 national survey based on OECD pilot questionnaire while data on Iceland come from Health and Wellbeing of Icelanders, follow-up survey 2009, and data for other countries come from the Commonwealth Fund's International Health Policy Survey 2010. 8
Unmet care needs: Medical tests, treatment or follow-up skipped due to costs, 2010 (preliminary) 3.4% 3.0% 2.8% 5.5% 5.4% 5.0% 4.5% 6.2% 9.5% 9.0% 14.0% 23.0% Total Female Male 0% 5% 10% 15% 20% 25% 30% Age-sex standardised rates (%) Source: Data on are from 2011 national survey based on OECD pilot questionnaire while data on Iceland come from Health and Wellbeing of Icelanders, follow-up survey 2009, and data for other countries come from the Commonwealth Fund's International Health Policy Survey 2010. 9
Unmet care needs: Prescribed medicine skipped due to costs, 2010 (preliminary) 12.8% 10.1% 8.5% 7.8% 7.3% 6.1% 5.8% 4.3% 4.1% 3.1% 1.9% 21.9% Total Female Male 0% 5% 10% 15% 20% 25% 30% Age-sex standardised rates (%) Source: Data on are from 2011 national survey based on OECD pilot questionnaire while data on Iceland come from Health and Wellbeing of Icelanders, follow-up survey 2009, and data for other countries come from the Commonwealth Fund's International Health Policy Survey 2010. 10
Prescribed medicine skipped due to costs Positive correlation between medical tests, treatment or follow-up skipped and prescribed medicine skipped due to costs (preliminary) 25% 20% R² = 0.8461 USA 15% 10% 5% LUX NLD GBR CAN SWE FRA NOR CHE NZL DEU 0% 0% 5% 10% 15% 20% 25% Medical tests, treatment or follow-up skipped due to costs Source: Data on are from 2011 national survey based on OECD pilot questionnaire while data on Iceland come from Health and Wellbeing of Icelanders, follow-up survey 2009, and data for other countries come from the Commonwealth Fund's International Health Policy Survey 2010. 11 AUS
Proposals for HAG 2013 Unmet care needs Consultation skipped due to difficulties in travelling Consultation skipped due to costs Medical tests, treatment or follow-up skipped due to costs Prescribed medicine skipped due to costs 12
Patient experiences: Regular doctor spending enough time with patient during the consultation, 2010 (preliminary) Total Female Male 95.5% 92.5% 91.5% 91.3% 89.6% 88.6% 85.4% 85.1% 81.4% 80.5% 78.0% 74.0% 0% 20% 40% 60% 80% 100% Age-sex standardised rates (%) Notes: data refer to patient experiences during the last consultation with any doctor and not specific to their experiences with regular doctor and response categories are "Yes, definitely', "Yes, to some extent", "No, not really", and "No, definitely not", instead of "Always", "Often", "Sometimes", and "Rarely or never" used in the Commonwealth Fund's survey. Source: Data on are from 2011 national survey based on OECD pilot questionnaire and data for other countries come 13 from the Commonwealth Fund's International Health Policy Survey 2010.
Patient experiences: Regular doctor providing easyto-understand explanations, 2010 (preliminary) Total Female Male 97.4% 96.0% 95.3% 94.7% 92.5% 91.0% 89.6% 89.5% 89.0% 89.0% 88.7% 81.4% 0% 20% 40% 60% 80% 100% Age-sex standardised rates (%) Notes: data refer to patient experiences during the last consultation with any doctor and not specific to their experiences with regular doctor and response categories are "Yes, definitely', "Yes, to some extent", "No, not really", and "No, definitely not", instead of "Always", "Often", "Sometimes", and "Rarely or never" used in the Commonwealth Fund's survey. Source: Data on are from 2011 national survey based on OECD pilot questionnaire and data for other countries come 14 from the Commonwealth Fund's International Health Policy Survey 2010.
Patient experiences: Regular doctor giving opportunity to ask questions or raise concerns, 2010 (preliminary) Total Female Male 95.3% 94.5% 93.9% 92.6% 92.3% 92.0% 88.5% 88.3% 87.0% 83.3% 82.9% 75.8% 0% 20% 40% 60% 80% 100% Age-sex standardised rates (%) Notes: data refer to patient experiences during the last consultation with any doctor and not specific to their experiences with regular doctor and response categories are "Yes, definitely', "Yes, to some extent", "No, not really", and "No, definitely not", instead of "Always", "Often", "Sometimes", and "Rarely or never" used in the Commonwealth Fund's survey. Source: Data on are from 2011 national survey based on OECD pilot questionnaire and data for other countries come 15 from the Commonwealth Fund's International Health Policy Survey 2010.
Regular doctor giving opportunity to ask questions or raise concerns Positive correlation between clear explanation and opportunity to ask questions (preliminary) 100% R² = 0.8242 95% GBR DEU NZL CHE NLD 90% CAN USA AUS 85% NOR FRA 80% 80% 85% 90% 95% 100% Regular doctor providing easy-to-understand explanations Notes: data refer to patient experiences during the last consultation with any doctor and not specific to their experiences with regular doctor and response categories are "Yes, definitely', "Yes, to some extent", "No, not really", and "No, definitely not", instead of "Always", "Often", "Sometimes", and "Rarely or never" used in the Commonwealth Fund's survey. Source: Data on are from 2011 national survey based on OECD pilot questionnaire and data for other countries come 16 from the Commonwealth Fund's International Health Policy Survey 2010.
Patient experiences: Regular doctor involving patient in decisions about care and treatment, 2010 (preliminary) Total Female Male 95.6% 91.8% 91.0% 89.6% 89.2% 87.9% 87.1% 85.9% 85.4% 85.3% 82.9% 74.1% 0% 20% 40% 60% 80% 100% Age-sex standardised rates (%) Notes: data refer to patient experiences during the last consultation with any doctor and not specific to their experiences with regular doctor and response categories are "Yes, definitely', "Yes, to some extent", "No, not really", and "No, definitely not", instead of "Always", "Often", "Sometimes", and "Rarely or never" used in the Commonwealth Fund's survey. Source: Data on are from 2011 national survey based on OECD pilot questionnaire and data for other countries come 17 from the Commonwealth Fund's International Health Policy Survey 2010.
Patient experiences: Regular doctor involving patient in decisions about care and treatment by age group, 2010 (preliminary) 65+ 45-64 24-44 18-24 0% 20% 40% 60% 80% 100% Notes: data refer to patient experiences during the last consultation with any doctor and not specific to their experiences with regular doctor and response categories are "Yes, definitely', "Yes, to some extent", "No, not really", and "No, definitely not", instead of "Always", "Often", "Sometimes", and "Rarely or never" used in the Commonwealth Fund's survey. Source: Data on are from 2011 national survey based on OECD pilot questionnaire and data for other countries come 18 from the Commonwealth Fund's International Health Policy Survey 2010.
Proposals for HAG 2013 Patient experiences Regular doctor spending enough time with patient during the consultation Regular doctor providing easy-to-understand explanations Regular doctor giving opportunity to ask questions or raise concerns Regular doctor involving patient in decisions about care and treatment 19