Foreword

At the 2017 OECD Ministerial Conference on the Next Generation of Health Reforms, Ministers called for improved efforts to strengthen the people-centredness of health systems. No recent event has more clearly demonstrated this need than the global COVID-19 pandemic. COVID-19 highlighted pre-existing weaknesses and failures of health systems, and underscored the need for improved analytical tools to help policy makers define how health systems are held accountable for performance and patient-centredness.

This includes ongoing work to develop a new generation of indicators that measure the outcomes and experiences of health care that matter most to people through the Patient-Reported Indicators Surveys (PaRIS), including the PaRIS International Survey for People Living with Chronic Conditions, as well as policy-oriented research aimed to develop a cross-country understanding of the extent to which person-centred policy making has taken hold in health systems.

This report is intended to respond to the urgent need for improved conceptual tools and analysis of how health systems deliver for the people who use them. It presents an OECD Framework and Scorecard for People-Centred Health Systems to help policy makers better understand health policy problems, from the perspective of the people. Five dimensions of people-centredness for health systems – voice, choice, co-production, integration and respectfulness – are identified as critical building blocks for a people-centred system. The report benchmarks the progress countries have made towards a more people-centred approach to health. It finds that despite widespread agreement on the importance of people-centredness, no countries have comprehensively implemented people-centred policies across all essential dimensions.

The report further applies the lens of people-centredness to examine the enormous impact that COVID-19 has had on people and health systems in OECD countries and beyond. It draws special attention to the impact of the COVID-19 pandemic on people-centredness, and discusses key policies to help move the needle towards more people-centred health systems in the OECD area, which are critical in both “normal” times and during health shocks and crises. It finds that countries have largely overlooked people-centredness in their pandemic response, underscoring the distance still to go to fully embed people-centred policy making in health systems.

This publication was prepared by the OECD Health Division under the co-ordination of Frederico Guanais and Elina Suzuki. It would not have been possible without the support of Nick Tomlinson, Michael van den Berg, Katherine de Bienassis, Gabriel di Paolantonio, José Bijlholt, and Tom Raitzik Zonenschein, and was aided immensely by input from Francesca Colombo, Mark Pearson, and Stefano Scarpetta. The authors would like to further extend their gratitude to the participants in the Health Committee and the many policy makers across OECD and partner countries who gave their time to responding to policy questionnaires and reviewing and commenting on draft chapters. This report would not have been possible without their generosity.