The Economist (Intelligence Unit) – Creating Healthy Partnerships (2019)

14

THE ROLE OF PATIENT VALUE AND PATIENT-CENTRED
CARE IN HEALTH SYSTEMS

Chapter 2: The Patient-Centred Care Scorecard

Introducing the scorecard

In order to examine the transition of healthcare systems to patient-centred care models, The

Economist Intelligence Unit created the Patient-Centred Care Scorecard. It assesses progress across

four domains in nine major economies around the world: Brazil, China, France, Germany, Italy, Japan,

Spain, the UK and the US. Assessment in these domains in turn reflects how these countries measure

against 11 representative indicators, which themselves rely on 26 sub-indicators.

The four domains are:

 Patient-centred strategies and policies, including formal policies, legal recognition of patient

rights, and using value-based payment systems as an incentive for the adoption of patient-

centred care.

 The delivery of care, including access, continuity of treatment and training in patient-centricity.

 The provision of care in a patient-centred way, including personalisation and patient involvement

in decision-making.

 The role of patients, including the use of patient-reported measurements, patient empowerment,

and the role and nature of patient groups in the measured countries.

The indicators and sub-indicators are of various types. Some are binary, recognising the existence or

not of a desirable element of patient-centred care, such as integration of relevant training in national

curricula or the use of patient-reported outcomes measure (PROMs) in routine care. Others are more

quantitative, such as the average number of minutes in a typical appointment with a clinician. Others

still rely on existing Economist Intelligence Unit output, such as the 2017 Global Access to Healthcare

Index (for a more detailed description of the domains and indicators, see the research report, “Adoption

of patient-centred care: Findings and Methodology; available at patientcentredcare.eiu.com).

Use of the scorecard requires two caveats. First, such an exercise is constrained by the availability of

internationally comparable data. Some indicators were difficult to include because the information

is not accessible or even existent. In other cases, we have used proxies, such as the length of clinical

appointments, to judge the ability of patients to discuss complex multi-morbidities in individual cases.

Second, a benchmarking exercise like the scorecard is impressionistic rather than precise. The

scores are a rough indicator of how countries are doing, especially in a field where success requires

simultaneous progress on all fronts. This tool, rather than a way to name winners and losers, is meant

to start discussions about existing strengths on which to build, and weaknesses that require attention.