“Health system performance assessment has become an area of increasing interest within the European Union. In April 2014 the European Commission adopted a Communication to propose an EU agenda on effective, accessible and resilient health systems. 
As a result a European consortium developed a consensus document in 2016 to facilitate the use of Patient Reported Outcome Measures (PROMs) by EU Member States to measure heath system performance. The report highlights the importance of international quality comparisons as a means to identify best practice across countries, and to trigger quality improvement initiatives at a national level (FIPRA, 2016).” 


The Challenge

In 2011, the introduction of the European Semester resulted in much stronger scrutiny of health spending at European level, including recommendations to Member States to improve the ‘cost-effectiveness’ of their health spending. 

However, the underlying analysis was based only overwhelmingly on cost and process data, with little attention given to what health systems actually deliver as regards improvements in people’s health – health outcomes. 

The FIPRA Approach

The aim of the Value of Health initiative was to provide a multi-stakeholder response – in particular by stressing the importance of measuring health outcomes as a tool to improve quality of care and public health. 

Multi-stakeholder collaboration, as well as ongoing engagement with the European Commission and OECD, enabled diverse perspectives and cross-country experiences to be shared. 

A first consensus document – Enhancing Value in European Health Systems: the role of outcomes measurement – was launched with cross-party support at the European Parliament in March 2016. The final report followed in September 2018. In each case, there were contributions and endorsement from leading patient groups, medical professionals, public health experts, academics, and industry. 

The Outcome

The work of the Value of Health initiative received high level endorsement: the Director-General for Health in the European Commission provided the foreword to the first consensus document and gave the keynote address at the launch event. The OECD Deputy Director for Employment, Labour and Social Affairs described the final report as ‘visionary’. 

The work included a strong focus on the need to measure outcomes from the patient perspective (by using patient-reported outcome measures). The findings were subsequently highlighted in the OECD’s recommendations to health ministers on the collection of patient-reported outcomes and experiences. 

In 2018, the European Commission’s State of Health in the EU Communication strongly emphasised the need to measure health outcomes from the patient perspective, and looked forward to the integration of such data in EU health systems analysis. 

The Value of Health initiative has thus made an important contribution to an ongoing paradigm shift at EU level – from a near exclusive on costs and processes, to the measurement of health outcomes.