title: International comparisons of health system performance among OECD countries: opportunities and data privacy protection challenges.
abstract: OBJECTIVE
  Health data constitute a significant resource in most OECD countries that could be used to improve health system performance. Well-intended policies to allay concerns about breaches of confidentiality and to reduce potential misuse of personal health information may be limiting data use. A survey of 20 OECD countries explored the extent to which countries have developed and use personal health data and the reasons why data use may be problematic in some.
  
  
  RESULTS
  Countries are divided, with one-half engaged regularly in national data linkage studies to monitor health care quality. Country variation is linked to risk management in granting an exemption to patient consent requirements; in sharing identifiable data among government authorities; and in project approvals and granting access to data. The resources required to comply with data protection requirements is a secondary problem. The sharing of person-level data across borders for international comparisons is rarely reported and there were few examples of studies of health system performance.
  
  
  CONCLUSIONS
  Laws and policies enabling data sharing and data linkage are needed to strengthen national information infrastructure. To develop international studies comparing health care quality and health system performance, actions are needed to address heterogeneity in data protection practices.
authors.affiliation: Organisation for Economic Co-operation and Development, 2, Rue André Pascal, 75775 Paris Cedex 16, France. Electronic address: jillian.oderkirk@oecd.org.
authors.forename: Jillian
authors.initials: J
authors.lastname: Oderkirk
authors.forename: Elettra
authors.initials: E
authors.lastname: Ronchi
authors.forename: Niek
authors.initials: N
authors.lastname: Klazinga
mesh_terms: D003219:Confidentiality / Q000592:standards*; D003695:Delivery of Health Care; D019049:Developed Countries; D019538:Health Care Surveys; D063025:Health Information Management / Q000592:standards*; D055991:Health Records, Personal
keywords: Data linkage; Data privacy; Data protection; Health system performance; International comparisons; Personal health data