title: Health care performance comparison using a disease-based approach: the EuroHOPE project.
abstract: This article describes the methodological challenges associated with disease-based international comparison of health system performance and how they have been addressed in the EuroHOPE (European Health Care Outcomes, Performance and Efficiency) project. The project uses linkable patient-level data available from national sources of Finland, Hungary, Italy, The Netherlands, Norway, Scotland and Sweden. The data allow measuring the outcome and the use of resources in uniformly-defined patient groups using standardized risk adjustment procedures in the participating countries. The project concentrates on five important disease groups: acute myocardial infarction (AMI), ischemic stroke, hip fracture, breast cancer and very low birth weight and preterm infants (VLBWI). The essentials of data gathering, the definition of the episode of care, the developed indicators concerning baseline statistics, treatment process, cost and outcomes are described. The preliminary results indicate that the disease-based approach is attractive for international performance analyses, because it produces various measures not only at country level but also at regional and hospital level across countries. The possibility of linking hospital discharge register to other databases and the availability of comprehensive register data will determine whether the approach can be expanded to other diseases and countries.
authors.affiliation: National Institute for Health and Welfare, Centre for Health and Social Economics (CHESS), Helsinki, Finland. Electronic address: unto.hakkinen@thl.fi.
authors.forename: Unto
authors.initials: U
authors.lastname: Häkkinen
authors.forename: Tor
authors.initials: T
authors.lastname: Iversen
authors.forename: Mikko
authors.initials: M
authors.lastname: Peltola
authors.forename: Timo T
authors.initials: TT
authors.lastname: Seppälä
authors.forename: Antti
authors.initials: A
authors.lastname: Malmivaara
authors.forename: Éva
authors.initials: É
authors.lastname: Belicza
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fattore
authors.forename: Dino
authors.initials: D
authors.lastname: Numerato
authors.forename: Richard
authors.initials: R
authors.lastname: Heijink
authors.forename: Emma
authors.initials: E
authors.lastname: Medin
authors.forename: Clas
authors.initials: C
authors.lastname: Rehnberg
mesh_terms: D019985:Benchmarking / Q000379:methods; D005060:Europe; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care / Q000592:standards*
keywords: Cost; Disease-based approach; Episode; Health care; Outcome; Performance measurement