"Reporting standards and clinical outcome metrics differ substantially across the system, even within the same specialty," Lawyer says. "There currently exists no national mechanism for compelling providers to report outcomes to disease registries. Nor is there a unique patient identifier in place that would enable research to combine data across different disease states to examine the effect of complex comorbidities.
"The report is one of the most detailed international comparisons of progress toward value-based healthcare, combining a top-down assessment of national enablers with a bottom-up assessment of data quality and use at existing disease registries across 12 major health conditions. It uses 35 specific assessment criteria developed on the basis of previous BCG research in the field, a comprehensive survey of the medical literature, and 139 interviews with representatives of national health departments and with international health-outcome experts, explains Stefan Larsson, MD, a BCG senior partner and coauthor of the report.
"We learned that a number of countries have begun to build the infrastructure and processes to support a value-based approach, but some are significantly farther along the learning curve than others," Larsson says. "Despite this differential in development and despite major differences in the structure and organization of national health-care systems, there is much to learn from each country."