the echo project: potential insights into equitable access ... · proper comparisons require proper...
TRANSCRIPT
![Page 1: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/1.jpg)
www.echo-health.eu
The ECHO project: potential insights into equitable access, quality and efficiency of health care in Europe
![Page 2: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/2.jpg)
www.echo-health.eu
Comparing health care systems: the usual way
• What are the health outcomes? • How much does it cost to get those outcomes? • Who pays for it? • Who benefits? • Which benefits? • How do they do it?
![Page 3: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/3.jpg)
www.echo-health.eu
What are we missing by using this approach?
• Variation is a local phenomenon, and…
• No variation might mislead conclusions • Proper attribution drives to action • Variation varies over time differently across areas • The relative impact on population´s health • Proper conclusions require proper comparisons
![Page 4: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/4.jpg)
www.echo-health.eu
Sweden: 43 per 1,000 inh. Spain: 45 per 1,000 inh.
No variation might mislead conclusions: knee replacement
![Page 5: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/5.jpg)
www.echo-health.eu
Proper attribution drives to action: PTA vs burden of disease
Region ICC: 0.4
![Page 6: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/6.jpg)
www.echo-health.eu
Variation varies over time differently across areas
PTA 2002-2009
![Page 7: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/7.jpg)
www.echo-health.eu
Prostatectomy in prostate cancer
The relative impact on population´s health
![Page 8: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/8.jpg)
www.echo-health.eu
Proper comparisons require proper adjustment
-2
-1,5
-1
-0,5
0
0,5
1
1,5
![Page 9: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/9.jpg)
www.echo-health.eu
… After pooling patients and risk adjustment
![Page 10: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/10.jpg)
www.echo-health.eu
ECHO: the project
• The consortium • Goals • Answering two questions • Performance model • Methods
![Page 11: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/11.jpg)
www.echo-health.eu
Goals
• Using established indicators adopted by international organisations, particularly those by AHRQ-OECD-EU, we will provide a set of accurate performance indicators
• Sound analysis of the actual performance of different providers at geographical and hospital levels
• Methodological insight into overcoming some of the classic hindrances for adequate performance measurement (ie, case-mix adjusted measures, Bayesian statistics, multilevel analyses, funnel plots, etc).
• Building tools to help decision-makers in taking informed decisions to tackle unwarranted variation.
![Page 12: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/12.jpg)
www.echo-health.eu
Does the place of residency influence
the population exposure to effective
and safe care?
Geographical-based approach
Is the likelihood of getting high-quality
and safe care dependant on the provider where a
person is assisted?
Hospital-specific approach
![Page 13: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/13.jpg)
www.echo-health.eu
3D ECHO performance model
![Page 14: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/14.jpg)
www.echo-health.eu
2 examples…
![Page 15: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/15.jpg)
www.echo-health.eu
ECHO: methods
• DWH building • Information analysis • Set of indicators (performance model)
• Methodological developments • Indicators validation • Risk adjustment measures • Flows analyses • Accounting for costs
• Health policy analyses on ECHO results
• Dissemination: Local feedback groups
![Page 16: The ECHO project: potential insights into equitable access ... · Proper comparisons require proper adjustment -2-1,5-1-0,5 0 0,5 1 1,5. … After pooling patients and risk adjustment](https://reader036.vdocuments.us/reader036/viewer/2022063010/5fc35517ae25412e3101d096/html5/thumbnails/16.jpg)
www.echo-health.eu
more at www.echo-health.eu