“In a context of rising health care costs driven principally by the increasing prevalence of chronic conditions, ageing populations and the high costs associated with technological advances in medicine, health care systems in Europe are nowadays facing the intricate challenge of delivering accessible, equitable and high-quality care while ensuring the sustainability of public finances.
At the same time, there is emerging consensus among policymakers and researchers that a significant share of current health care spending in modern health systems could be reallocated to better use
without undermining access and quality of care. As a result, European governments are increasingly interested in capturing opportunities to extract additional value from available resources, and increase the efficiency of their health care systems to tackle this twofold challenge.
Yet while the idea of efficiency in this context – that is, how well a health care system uses its resources (input) to improve population health (outcome) – is simple to understand, several methodological questions remain on how to correctly identify inefficiencies within health care systems and devise corrective interventions without unintended consequences on access or quality of care.
The relationship between health system inputs and health outcomes is complex and influenced by several factors that are typically outside of the control of the health system, which makes it difficult to measure the effect of specific care interventions on health outcomes and perform fair comparative
assessments across entities. Together with considerable data limitations affecting analysts’ capacity to capture the performance of different segments of the ‘health production process’, assessing health care efficiency becomes a very complex endeavour in practice.
In light of these difficulties, specifying a set of appropriate instruments to analyse, measure
and assess efficiency of care (as well as spelling out their limitations) is a precondition for policymakers to design and implement interventions that can effectively make use of the ample potential to increase
efficiency mentioned above.
In support of this undertaking, among its activities over the course of 2018 the Expert Group on Health Systems Performance Assessment (HSPA) produced this report on tools and methodologies to assess efficiency of care. The report sets out to explore the most recent theory and observed practice of
health care efficiency measurement and assessment across European countries, in view of discovering what opportunities exist for European countries to improve their tools and methods to measure and assess efficiency of care, and to make better use of efficiency information for policy formation.”