Achieving high quality primary care is a key priority in nearly every OECD country, given increasing prevalence of chronic illnesses, quicker discharges from hospitals and rising public expectations of seamless, coordinated care.

Most health systems have developed a “primary level” of care whose functions include managing new health complaints that pose no immediate threat to life, managing long-term conditions and supporting the patient in deciding when referral to hospital-based services is necessary. Governments are increasingly stressing the importance of primary care as an alternative to expensive hospital care and are looking for ways to measure and improve the quality of the primary care sector.

Through the use of a structured expert review process, the HCQI project initially identified rates of avoidable admissions for long-term conditions and rates of lower limb amputation in diabetics as valid, internationally comparable indicators of the quality of primary care. Further indicators on the quality and safety of prescribing in primary care have subsequently been developed.

At present, primary care HCQI include:

• Asthma hospital admission rates
• COPD hospital admission rates
• Congestive heart failure hospital admission rates
• Hypertension hospital admission rates
• Diabetes hospital admission rates
• Diabetes lower extremity amputation rates
• Diabetic patients with at least one prescription of cholesterol lowering medication
• Diabetic patients with prescription of first choice antihypertensive medication
• Elderly patients with prescription of long-term benzodiazepines or related drugs
• Elderly patients with prescription of long-acting benzodiazepines or related drugs
• Patients with long-term prescription of any anticoagulating drug in combination with an oral NSAID
• Total volume of antibiotics for systemic use
• Volume of second line antibiotics as a share of total volume
• Rate of childhood vaccination for pertussis
• Rate of childhood vaccination for measles
• Rate of influenza vaccination for elderly people
  
  

 

DATA

The HCQI indicators are published within Health at a Glance 2015: Chapter 8 on Quality of Care.

Additional indicators are also available in the OECD Health Statistics database in the Health Care Quality Indicators dataset in OECD.Stat:

• Primare Care
• Prescribing in Primary Care
  
  

PUBLICATIONS 

• Selecting Indicators for the Quality of Health Promotion, Prevention and Primary Care at the Health Systems Level in OECD Countries, Health Technical Papers No. 16
• Selecting Indicators for the Quality of Diabetes Care at the Health Systems Level in OECD Countries, Health Technical Paper No. 15
  
  

CONTACT

Ian Brownwood: ian.brownwood@oecd.org