Reviews of National Health Care Quality


OECD Health Care Quality Reviews provide a toolkit to improve the quality of health care

Over the past four years, the OECD has conducted a series of in-depth reviews of the policies and institutions that underpin the measurement and improvement of health care quality in 15 different health systems. Caring for Quality in Health: Lessons learnt from 15 reviews of health care quality seeks to answer the question of what caring for quality means for a modern health care system by identifying what policies and approaches work best in improving quality of care.

Despite differences in health care system priorities, and in how quality-improvement tools are designed and applied, a number of common approaches and shared challenges emerged across the 15 OECD Reviews of Health Care Quality analysed. The most important of these concerns transparency. Governments should encourage, and where appropriate require, health systems and health care providers to be open about the effectiveness, safety and patient-centredness of care they provide.

More measures of patient outcomes are also needed - especially those reported by patients themselves. These should underpin standards, guidelines, incentives and innovations in service delivery. Greater transparency can lead to optimisation of both quality and efficiency – twin objectives which reinforce, rather than subvert, each other. In practical terms, greater transparency and better performance can be supported by changes in where and how care is delivered; changes in the roles of patients and professionals; and employing tools such as data and incentives more effectively. Key actions in these three areas are set out in the 12 lessons presented in this synthesis report.



  • OECD countries spent nearly a tenth of their GDP on health. As spending rises, there is pressure to ensure that resources help people live healthier lives
  • Most OECD countries have seen increased public interest in ensuring that patients receive care that is safe, effective, and responsive to their needs
  • OECD Health Care Quality and Outcomes indicators show wide variations in quality across OECD countries, yet little is known about the policies that sit behind the numbers


DG-REFORM-Co-Funded by the EU

The Health Division of the OECD and the DG REFORM of the European Commission are cooperating in providing technical support to countries to establish Health System Performance Assessment (HSPA) programs:
  • Setting up a framework for Health System Performance Assessment in the Czech Republic

The Ministry of Health of the Czech Republic requested technical assistance from the European Commission and the OECD to support the reform process and enable the national authorities in the Czech Republic to implement an institutional framework for reporting health system performance indicators.
The ongoing project aims to analyse the current health data governance landscape. The OECD is also reviewing best practices internationally and providing policy recommendations. As part of the project, the OECD is carrying out a series of workshops and focus group discussions, as well as supporting an international HSPA study exchange. The project will result in a HSPA Framework, Methodology, and Governance plan.

  • Health System Performance Assessment framework for Estonia

The Ministry of Social Affairs of Estonia has requested technical assistance from the European Commission and the OECD to support the reform process for developing a national health system performance assessment framework. The ongoing project aims to enable national authorities in Estonia to have a clear health information system governance and an agreement on a systematised list of health system monitoring indicators and objectives.
As part of the project, the OECD is carrying out a series of workshops and focus group discussions, as well as supporting local capacity-building to support the sustainability of the HSPA process. The project has resulted in a report assessing the state of the national health information infrastructure and governance. This work will be used to inform the development of the Estonian HSPA Framework, Methodology, and Governance plan, which will be delivered at the end of this ongoing project.

The Health Division of the OECD is also supporting the Dubai Health Authority in developing and implementing a new HSPA framework.

Dubai-HSPA-Framework Establishing a Health System Performance Assessment Framework for Dubai

The Dubai Health Authority of the United Arab Emirates has requested technical assistance from the OECD to assess the state of the health information infrastructure and support the creation and implementation of a Health System Performance Assessment Framework. The initial project consisted of four parts: 1) the development of an HSPA framework for Dubai, 2) assessment of the health data infrastructure, 3) the selection of indicators, and 4) analysis and reporting of the first HSPA report.


Access the country reports and their press releases when clicking on the links below. Also available on the OECD iLibrary.

For a description of the health system in these countries and many others, visit the European Observatory's Health Systems in Transition (HiT) series.



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