Improved Health System Performance through better Care Coordination

Abstract

This report attempts to assess whether -- and to what degree - better care coordination can improve health system performance in terms of quality and cost-efficiency. Coordination of care refers to policies that help create patient-centred care that is more coherent both within and across care settings and over time. Broadly speaking, it means making health-care systems more attentive to the needs of individual patients and ensuring they get the appropriate care for acute episodes as well as care aimed at stabilising their health over long periods in less costly environments. These issues are of particular interest to patients with chronic conditions and the elderly who may find it difficult to "navigate" fragmented health-care systems that are often found in OECD countries. Interest in coordination of care issues is increasing Growing interest in these issues has reflected a shift in the demands placed on health-care services. Chronic conditions have become progressively more important and are absorbing a growing share of health-care budgets. Since most of the chronically ill are elderly, this share can be expected to rise as populations age over coming decades. At the same time, many reports suggest that the quality of care that the chronically ill receive may need improvement. With these developments occurring in a context of tight public finance, some countries have been attempting to improve both the quality of care provided to the chronically ill and reduce cost pressures via changes to the architecture of health-care systems that encourage greater care coordination... L'objet de ce rapport est de tenter d'apprécier si - et, le cas échéant, dans quelle mesure - une meilleure coordination des soins est susceptible d'améliorer la performance des systèmes de santé en termes de qualité et d'efficience au regard du coût. Par coordination des soins on entend les mesures de nature à aider à instaurer une prise en charge centrée sur le patient qui soit plus cohérente aussi bien à l'intérieur d'un même cadre de soins qu'entre différents cadres de soins, et dans le temps. Plus généralement, il s'agit de faire en sorte que les systèmes de santé soient plus attentifs aux besoins individuels des patients et de faire en sorte que ceux-ci reçoivent les soins appropriés à l'occasion d'épisodes aigus, ainsi que des soins destinés à stabiliser leur état de santé, dans une perspective à long terme, dans un environnement moins coûteux. Ces questions revêtent une importance toute particulière pour les malades chroniques et pour les personnes âgées qui trouveront sans doute difficile de « naviguer » à l'intérieur de systèmes de santé fragmentés comme c'est souvent le cas dans les pays de l'OCDE. On s'intéresse de plus en plus à la problématique de la coordination des soins L'intérêt croissant pour cette question reflète un déplacement des attentes à l'égard des services de santé. Les maladies chroniques sont de plus en plus fréquentes et absorbent une part croissante des budgets de santé. Les maladies chroniques concernant, le p...

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