The current status of decision-making procedures and quality assurance in Europe: an overview

Scientific Contribution

Abstract

The 2005 Report on Social Responsibility and Health of the UNESCO International Bioethics Committee (Ibc) proposes a new approach to implementing the right to healthcare and suggests a number of Courses of Action to be followed in various fields. Based on the latest available data, we intend to present an overview of the current state of European health systems in two of those fields—decision-making procedures and quality assurance in health care—and to attempt a comparison of the situation with the Report’s provisions, in order to pave the way for the identification of what still has to be done to bridge international recommendations and the reality of policy and practice in Europe’s health care.

Keywords

Health systems Healthcare Equality Social responsibility Solidarity Europe Basic goods Health care rationing Quality assurance Health care UNESCO 

References

  1. Bal, R., W. Bijker, and R. Hendriks. 2002. Paradox van wetenschappelijk gezag. Over de maatschappelijke invloed van adviezen van de Gezondheidsraad, 1985–2001. Den Haag: Gezondheidsraad.Google Scholar
  2. Bal, R., and A. van de Lindeloof. 2006. Publieksparticipatie bij pakketbeslissingen: Leren van buitenlandse ervaringen. In Zicht op zinnige en duurzame zorg—Achtergrondstudie. Raad voor de Volksgezondheid en Zorg, Den Haag.Google Scholar
  3. BQS website. Duesseldorf, German Federal Agency for Quality Assurance. http://www.bqs-online.de/. Accessed Oct 2010.
  4. Berg, M., and T. van der Grinten. 2003. The Netherlands. In Reasonable rationing: International experience of priority setting in health care, ed. C. Ham, and G. Robert. Philadelphia: Open University Press.Google Scholar
  5. Berg, M., T. van der Grinten, and N. Klazinga. 2004. Technology assessment, priority setting and appropriate care in Dutch health care. International Journal of Technology Assessment in Health Care 20(1): 35–43.PubMedCrossRefGoogle Scholar
  6. Calltorp, J. 1999. Priority setting in health policy in Sweden and a comparison with Norway. Health Policy 50: 1–22.PubMedCrossRefGoogle Scholar
  7. Canadian Health Services Research Foundation. 2006. Myth: People use health system report cards to make decisions about their healthcare. http://www.chsrf.ca/mythbusters/html/myth23_e.php. Accessed Oct 2010.
  8. Council of Europe 1997. Appendix to Recommendation R (97)17 of the Committee of Ministers to member states on the development and implementation of quality improvement systems (QIS) in health care. www.coe.int/t/dg3/health/Source/Rec(97)17memo_en.doc. Accessed May 2011.
  9. CPSS. 2007. Opinion barometer 2007. Bucharest, Centre for Health Policies and Services. http://www.cpss.ro. Accessed Oct 2010.
  10. Charles, C., and S. Lay DeMaio. 1993. Participation in health care decision making: A conceptual framework. Journal of Health Politics, Policy and Law 18(4): 881–904.Google Scholar
  11. Cheng, T.M, and U. Reinhardt. 2008. Shepherding major health system reforms: A conversation with German health minister Ulla Schmidt. Health Affairs 27(3): w204–w209.Google Scholar
  12. Commissie Keuzen in Zorg, Commissie Dunning. 1991. Kiezen en delen. Rijswijk: Ministerie van Welzijn, Volksgezondheid en Cultuur.Google Scholar
  13. Commissie Structuur en Financiering Gezondheidszorg. 1987. Bereidheid tot verandering. Rapport. Den Haag: SDU.Google Scholar
  14. Council of Europe. 2001. Recommendation Rec (2001)13 on developing a methodology for drawing up guidelines on best medical practices and explanatory memorandum of the Council of Europe. Strasbourg, Council of Europe.Google Scholar
  15. Council of Europe. 2006. Recommendation Rec(2006)7 of the Committee of Ministers to member states on management of patient safety and prevention of adverse events in health care. Strasbourg, Council of Europe.Google Scholar
  16. DACEHTA website. 2007. Copenhagen, danish centre for health technology assessment. http://www.sst.dk/Global/leksikon/MTV.aspx. Accessed Oct 2010.
  17. Daniels, N. 2000. Accountability for reasonableness. British Medical Journal 321(7272): 1300–1301.PubMedCrossRefGoogle Scholar
  18. Department of Health. 1991. Assessing the effects of health technologies. Department of Health, London.Google Scholar
  19. Department of Health. 2000. An organisation with a memory. Report of an expert group on learning from adverse events in the NHS. London; The Stationery Office.Google Scholar
  20. EC. 2008. COM (2008) 836 final: Council Recommendation on patient safety, including the prevention and control of healthcare associated infections. Brussels, 20 Jan 2009.Google Scholar
  21. Edgar, W. 2000. Rationing health care in New Zealand—How the public has a say. In The global challenge of health care rationing, ed. A. Coulter, and C. Ham. Philadelphia: Open University Press.Google Scholar
  22. CASPE Research External Peer Review Techniques Project. 1998. ExPeRT. Peer review systems in Europe, London.Google Scholar
  23. Gezondheidsraad. 2003. Contouren van het basispakket. Den Haag: Gezondheidsraad.Google Scholar
  24. Groenewegen, P.P., J.J. Kerssens, H.J. Sixma, I. van der Eijk, and W. Boerma. 2005. What is important in evaluating health care quality? An international comparison of user views. BMC Health Services Research 5: 16.PubMedCrossRefGoogle Scholar
  25. Guidelines International Network. 2007. Guidelines International Network G-I-N. European Guideline Programmes. Berlin: Guidelines International Network.Google Scholar
  26. Hansen, K. 2000. Deliberative democracy—Experiments with public involvement in decision-making. Bordeaux.Google Scholar
  27. Harbers, H. 1996. De politiek van de technologie. Kennis and Methode 20(3): 308–315.Google Scholar
  28. Harrison, S., and M. Mort. 1998. Which champions, which people? Public and user involvement in health care as a technology of legitimation. Social Policy and Administration 32(1): 60–70.Google Scholar
  29. Hassenteufel, P., and B. Palier. 2009. Towards Neo-Bismarckian health care states? Comparing health insurance reforms in Bismarckian welfare systems. In Reforming the Bismarckian welfare systems, ed. B. Palier, and C. Martin. Oxford: Blackwell Publishing Ltd.Google Scholar
  30. Health Care and Medical Priorities Commission. 1993. No easy choices: The difficult priorities of healthcare. Scotkholm, Ministry of Health and Social Affairs.Google Scholar
  31. Health Systems in Transition. Belgium. 2010. European observatory on health systems and policies.Google Scholar
  32. Health Systems in Transition. Czech Republic. 2009. European observatory on health systems and policies.Google Scholar
  33. Health Systems in Transition. The Netherlands. 2009. European observatory on health systems and policies.Google Scholar
  34. Health Systems in Transition. Denmark. 2007. European observatory on health systems and policies.Google Scholar
  35. Holm, S. 1998. Goodbye to the simple solutions: The second phase of priority setting in health care. BMJ 317: 1000–1002.Google Scholar
  36. Hoedemaekers, R., and W. Dekkers. 2003. Justice and solidarity in priority setting in health care. Health Care Analysis 11(4): 325–343.PubMedCrossRefGoogle Scholar
  37. Hulst, E. 1999. The quality dimension of the right to health care. In The right to health care in several European countries-studies in social policy, nr. 5, Kluwer Law International, Den Haag.Google Scholar
  38. Goetz, A.M., and J. Gaventa. 2001. Bringing citizen voice and client focus into service delivery. Brighton: Institute of Development Studies at the University of Sussex.Google Scholar
  39. IOM. 1990. Medicare: A strategy for quality assurance, vol. 1. Washington: National Academy Press.Google Scholar
  40. Klazinga, N. 2000. Re-engineering trust: The adoption and adaption of four models for external quality assurance of health care services in western European health care systems. International Journal for Quality in Health Care 12(3): 183–189.Google Scholar
  41. Klein, R. 1998. Puzzling out priorities. Why we must acknowledge that rationing is a political process. BMJ 317: 959–960.PubMedGoogle Scholar
  42. Kunnamo, I. 2005. Finnish medical society: “EBM Guidelines” (EBMG) for primary care. Weybridge: Health Informatics Europe and BJHG Ltd.Google Scholar
  43. Lecluysea, A., et al. 2009. Hospital supplements in Belgium: Price variation and regulation. Health Policy 92: 276–287.CrossRefGoogle Scholar
  44. Legido-Quigley, H., M. McKee, E. Nolte, I.A. Glinois. 2008. Assuring the quality of health care in the European Union—A case for action. World Health Organization, on behalf of the European Observatory on Health Systems and Policies.Google Scholar
  45. Leu, R.E. et al. 2009. The Swiss and Dutch health insurance systems: Universal coverage and regulated competitive insurance markets, The Commonwealth Fund.Google Scholar
  46. Lippert-Rasmussen, K. 2006. The badness of discrimination. Ethical Theory and Moral Practice 9: 167–185. doi:10.1007/s10677-006-9014-x.CrossRefGoogle Scholar
  47. Maarse, H., and A. Paulus. 2003. Has solidarity survived? A comparative analysis of the effect of social health insurance reform in four European Countries. Journal of Health Politics, Policy and Law 28(4): 585–614.Google Scholar
  48. Martin, D.K., and S.R. Benatar. 2008. Resource allocation: International perspectives on resource allocation. In International encyclopedia of public health, ed. H.K. Heggenhougen, and S.R. Quah, 540. Amsterdam: Elsevier.Google Scholar
  49. Maxwell, R.J. 1992. Dimensions of quality revisited: From thought to action. Qualityin Health Care 1: 171–177.CrossRefGoogle Scholar
  50. McLeod, L., B. Bereza, M. Shim, and P. Grootendorst. 2011. Financial burden of household out-of-pocket expenditures for prescription drugs: Cross-sectional analysis based on national survey data. 2011. Open Medicine, North America. Available at http://www.openmedicine.ca/article/view/381. Accessed 03 June 2011.
  51. Saunders, Elsevier. 2003. Miller-Keane encyclopedia and dictionary of medicine, nursing, and allied health, seventh edition. Saunders, Elsevier, Inc. All rights reserved.Google Scholar
  52. Mossialos, E., and D. King. 1999. Citizens and rationing: Analysis of a European survey. Health Policy 49(1–2): 75–135.PubMedCrossRefGoogle Scholar
  53. Newhouse, J.P. 1993. Free for all? Lessons from the RAND health insurance experiment. Cambridge: Harvard University Press.Google Scholar
  54. Norheim, O.F. 2003. Norway. In Reasonable rationing: International experience of priority setting in health care, ed. C. Ham, and G. Robert. Philadelphia: Open University Press.Google Scholar
  55. Oevretveit, J. 2001. Quality evaluation and indicator comparison in health care. International Journal of Health Planning Management 16: 229–241.CrossRefGoogle Scholar
  56. Ollenschlaeger, G., and I. Kopp. 2007. The German program for disease management guidelines. Results and perspectives. Medizinische Klinik 102: 383–387.CrossRefGoogle Scholar
  57. Ottes, L., and A.J.G. van Rijen. 2006. Prioriteiteninstelling in de gezondheidszorg: Een inventarisatie van de bevindingen van (regerings)commissies in binnen- en buitenland. In Zicht op zinnige en duurzame zorgAchtergrondstudie. Raad voor de Volksgezondheid en Zorg, Den Haag.Google Scholar
  58. Paris, V., M. Devaux, and L. Wei. 2010. OECD health working papers no. 50. Health systems institutional characteristics: A survey of 29 OECD countries. OECD Directorate for employment, labour and social affairs.Google Scholar
  59. Rawlins, M. 1999. In pursuit of quality: The national institute for clinical excellence. Lancet 353: 1079–1083.PubMedCrossRefGoogle Scholar
  60. Rhodes, R. 2008. Resource allocation: Justice and resource allocation in public health. In International encyclopedia of public health, ed. H.K. Heggenhougen, and S.R. Quah. Amsterdam: Elsevier.Google Scholar
  61. Robinson, R. 2002. User charges for health care. In Funding health care: Options for Europe. European observatory on health care systems series, ed. E. Mossalos, A. Dixon, J. Figueras, and J. Kutzin. Buckingham-Philadelphia: Open University Press.Google Scholar
  62. Rowe, R., and M. Shepherd. 2002. Public participation in the new NHS: No closer to citizen control? Social Policy and Administration 36(3): 275–290.CrossRefGoogle Scholar
  63. Rubin, R., and D. Mendelson. 1995. A framework for cost sharing policy analysis. In Sharing the costs of health: A multi-country perspective, ed. N. Mattison. Basle: Pharmaceutical Partners for Better Health.Google Scholar
  64. Sabik, L.M., and R.K. Lie. 2008. Priority setting in health care: Lessons from the experiences of eight countries. International Journal of Equity Health 7: 4.Google Scholar
  65. Schieber, G., and A. Maeda. 1997. A curmudgeon’s guide to financing health care in developing countries. In Innovations in health care financing, ed. G. Schieber. Washington: World Bank.CrossRefGoogle Scholar
  66. Shaw, C., C. Bruneau, B. Kutryba, G. de Jongh, and R. Sunol. 2010. Towards hospital standardization in Europe. International Journal of Quality Health Care 22(4): 244–249.CrossRefGoogle Scholar
  67. Shaw, C., and I. Kalo. 2002. A background for national quality policies in health systems. Copenhagen: WHO Regional Office for Europe.Google Scholar
  68. Somekh, D. 2007. Working package 2: Mapping exercise of activities related to patient safety in EU countries. London: The ESQH Office for Patient Safety.Google Scholar
  69. Stevens, F.C.J., and J. van der Zee. 2008. Health system organization models. In International encyclopedia of public health, ed. H.K. Heggenhougen, and S.R. Quah. Amsterdam: Elsevier.Google Scholar
  70. Swedish Parliamentary Priorities Commission. 1995. Priorities in health care: Ethics, economy, implementation. Stokholm: Ministry of Health and Social Affairs.Google Scholar
  71. Tenbensel, T. 2002. Interpreting public input into priority-setting: The role of mediating institutions. Health Policy 62(2): 173.PubMedCrossRefGoogle Scholar
  72. UNESCO. 2005. Universal declaration on bioethics and human rights. Paris.Google Scholar
  73. UNESCO. 2010. Report of the international bioethics committee on social responsibility and health. Paris.Google Scholar
  74. Van der Zee, J., W.G.W. Boerma, and M.W. Kroneman. 2004. Health care systems: Understanding the stages of development. In Oxford textbook of primary medical care, vol. 1, ed. R. Jones, N. Britten, L. Culpepper, D.A. Gass, R. Grol, D. Mant, and C. Silagy. Oxford: Oxford University Press.Google Scholar
  75. Wagstaff, A. 2009. Policy research working paper #4821. Washington, DC: The World Bank; Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD.Google Scholar
  76. Whitehead, M. 1991. The concepts and principles of equity and health. Health Promotion International 6(3): 217–228.Google Scholar
  77. WHO. 2000. The World Health Report 2000. Health systems: Improving performance. Geneva: World Health Organization.Google Scholar
  78. Wiseman, V., G. Mooney, G. Berry, and K.C. Tang. 2003. Involving the general public in priority setting: Experiences from Australia. Social Science and Medicine 56: 1001–1012.PubMedCrossRefGoogle Scholar
  79. Witter, S., and T. Ensor. 1997. An intro to health economics for Eastern Europe and the Former Soviet Union. Chichester: Wiley.Google Scholar
  80. Xu, K., D.B. Evans, K. Kawabata, R. Zeramdini, J. Klavus, and C.J.L. Murray. 2003. Household catastrophic health expenditure: A multicountry analysis. Lancet 362: 111–117.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.European Public Health Association (EUPHA)UtrechtThe Netherlands

Personalised recommendations