Improving the quality of care for people with chronic conditions is central to advancing universal health coverage. Given rapid population ageing, changes are needed in how to pay for chronic care that provides incentives for quality.
On 10 October 2023, the WHO Centre for Health Development (WHO Kobe Centre – WKC) and the Organisation for Economic Co-operation and Development (OECD) released a number of publications dedicated to identifying ways to pay for quality chronic care to ensure good health and physical functioning among adults, including older people. These reports aim to collate the existing evidence on effect of payment methods on quality and outcome for chronic care, while commissioning new studies to understand the mechanisms that can explain this impact. WKC collaborated with the OECD and eight country research teams (Australia, Canada, Chile, China, Germany, Indonesia, South Africa and Spain) to carry out case studies on implementation arrangements for payment methods that reward quality for chronic care. It is hoped that this encourages sharing of lessons learned across different settings.
Among the findings of this research was that healthcare delivery models should be the focus of payment arrangements, and more efforts are needed to systematically identify obstacles that inhibit quality. This may enable policymakers to focus on quality and health outcomes for the population as a whole and to identify the appropriate mix of purchasing mechanisms that support service delivery reforms to achieve quality objectives for older people.
Evidence also points out the importance of learning from past experiences about the design and evaluation of payment methods, including how lessons learned can be systematically adapted across different country contexts. The lessons learned from this research study may be useful for countries that are looking to other settings for experiences in optimizing purchasing arrangements and payment methods to provide better quality care for patients with chronic diseases.
Publications and related documents can be accessed from the links below:
- Summary report
- Policy brief series
- Case studies: Australia, Canada, Chile, China, Germany, Indonesia, South Africa and Spain
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