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OECD Health Working Paper No. 142, May 2022,

Eliana Barrenho, Philip Haywood, Candan Kendir and Niek Klazinga

Across OECD countries, two in three people aged over 65 years live with at least one chronic condition often requiring multiple interactions with different providers, making them more susceptible to poor and fragmented care. This has prompted calls for making health systems more people-centred, capable of delivering high-quality integrated care. Despite promising, mostly local-level, experiences, systems remain fragmented, focused on acute care and unsuitable to solve complex needs. Moreover, assessing and comparing the benefits of integrated care remains difficult given the lack of technically sound, policy-relevant indicators. This report presents the results of the first OECD pilot of a new generation of indicators to support international benchmarking of quality of integrated care. Lessons from the pilot call for further work on: (1) expanding work on indicator development; (2) performing policy analysis to understand cross-country variations on governance models and health financing; (3) upscaling data linkage; and (4) measuring care fragmentation.

The report provides five key messages:

1. When reviewing national best practices, countries collect a growing volume of data but the lack of systematic data linkage at patient level undermines the value of the data to inform performance measurement for integrated care.
2. The 2020-2021 OECD pilot data on Integrated Care covered 15 countries and developed a new generation of indicators on mortality, readmissions and prescribed medicines for post-discharge care in stroke and congestive heart failure using linked data at patient level over a six-year period.
3. The pilot showed data collection is feasible, but linkage remains a challenge – 15 countries submitted data on mortality and readmissions but only four countries (Czech Republic, Denmark, Finland and Sweden) provided post-discharge medicine prescription data.
4. Data analysis suggests that OECD average masks large cross-country variations in outcomes within one year after discharge while trend analysis within countries shows improvements in outcomes. More analysis with multiple indicators and increased data linkages are required to measure integrated care.
5. To improve the international comparability of future data collections the OECD will refine the indicators and integrate into routine data collections the indicators on mortality and readmissions for post-discharge care in ischaemic stroke and congestive heart failure.

IFIC welcomes this report as a valuable contribution to the ongoing discussion of how to best measure integrate care. We believe it will be a good summer read to our global network.

Read the paper International comparisons of the quality and outcomes of integrated care

A Supplementary Analysis is available to complement this publication as well as the 2020-2021 OECD Data Collection Guidelines supporting the pilot data collection.

Please consult https://www.oecd.org/health/integrated-care.htm for more detailed information about ongoing OECD work on Integrated Care.

The Integrated Care Workforce: What does it need? Who does it take?

This special collection seeks to bring together papers that explore all facets of an integrated care workforce. We understand the integrated care workforce to comprise health and social care professionals, carers, volunteers, etc. but we are open to being challenged on this point. 

This special collection is keen to receive original papers under the three categories:

• Policy papers;
• Research and Theory papers; and
• Integrated Care Cases.

The publication of the special collection seeks to coincide with ICIC23 that will be convened in Antwerp, Belgium from 23-25 May 2023.

Deadlines
Submission deadline: 31st October 2022
Expected publication launch of special collection: May 2023

For further details, please download the full call for papers.

A group of researchers led by Co-editors-in-chief Prof. Robin Miller (University of Birmingham) and Prof. Viktoria Stein (Leiden University Medical Centre) are currently recruiting interviewees for their ongoing research in leadership and management of integrated care. A key part of this is the establishment of equal partnerships and working relationships with citizen leaders. In this study, citizen leaders are people who have used their experience to speak out and help to shape integrated care services for individual benefit and for the general good. If you would answer yes to the following questions, please get in touch:

• Have you accessed health and / or social care services as a patient / service recipient or as a family caregiver?
• Have you contributed to activities relating to the review, development or oversight of health and care services, or spoken out as a campaigner or activist to make services better?
• Have these activities been seeking to make services more integrated (i.e. person-centred and coordinated across professionals and services)? 

You can email us at R.S.Miller@bham.ac.uk or k.v.stein@lumc.nl. We would love to hear from you!