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

16

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

Interpreting these requires further context. The indicators measure, by and large, foundational

necessities of patient-centred care rather than challenging, long-term aspirations. For example, they

include the existence of a patient bill or statement of rights; the availability of reliable information for

patients on their condition; and easy scheduling of appointments with one’s usual physician. These

should be straightforward to achieve.

And as noted previously, the transition to patient-centred care requires change in a host of areas to be

truly meaningful. Every element is important for the whole to work. For example, integrated care that

notionally involves consultation with patients on their preferences but that neither pays the clinicians

for the time involved in such discussions nor gives those being treated the support they need to make

informed choices will fall far short of the goal.

This means that a good national result on the scorecard would involve high scores across domains and

indicators. Table 2 shows that this is far from being the case. It uses the actual scores that countries

have received compared with the number of points available. It then converts these numbers into an

assessment of whether health systems are highly, moderately or poorly aligned with patient-centred

care on each indicator. A country that has all the foundations in place to allow the development of

patient-centred care would have all high scores.

Table 1: Patient Centred Care Scorecard by domain, indicators and sub-indicators (using numeric values for scoring)

Domain # Indicator Sub-indicator Score

range

Brazil China France GermanyItaly Japan SpainUK US

Patients 4.1 Use of patient-

reported outcome

measures (PROMs)

Use of PROMs in routine care 0-2 0 0 0 0 0 0 0 1 0

Patient validation of PROMs 0 0 0 0 0 0 0 0 0

4.2 Patient advocacy

groups

Existence of independent patient

organisations with transparent funding

0-4 1 1 2 1 1 1 1 2 2

Patient/patient organisations

involvement in policy development

(eg, national plans/strategies/Health

Technology Assessment [HTA])

1 0 1 1 1 1 1 1 1

Patient/patient organisations

involvement in monitoring activities for

policy implementation (eg, national

plans/strategies/HTA)

0 0 0 0 0 0 0 0 0

4.3 Patient

empowerment

Availability of reliable patient

information (targeted at patients)

0-3 1 0 1 1 1 1 1 1 1

Availability of health education

initiatives (targeted at the general

population)

1 1 1 1 1 1 1 1 1

Use of patient empowerment

assessment tools by healthcare

providers

0 0 0 0 0 0 0 1 1

Source: For a detailed explanation of the scoring, see the research report, “Adoption of patient-centred care: Findings and Methodology ”, February 2019 (available

at: patientcentredcare.eiu.com)