Nordic hospital comparison study group (NHCSG)

In recent years there have been growing interest and efforts to compare the relative performance of various health systems. Many countries are developing national performance measurement frameworks which usually mean a collection of 'balanced scorecard' -type performance indicators. Relevant and comparable performance measures are believed to serve as measures of the efficiency and outcomes of various health policies and health care systems. Thus, this type of information should help policy makers to use evidence-based approach in identifying socially optimal structures in the provision and financing of health care.

The general aim of the network is to develop performance indicators for hospital care in the four Nordic countries. At the first stage, the emphasis will be on production performance, namely productivity and technical efficiency. Similar definitions for cost and output measures are used to calculate aggregate indices of efficiency in the production of patient care. In addition, we will innovate and test other types of (process) indicators which allow us to compare the structure and process of hospital care provision.

At second stage we will to explain the differences observed in the indicators developed in the first stage of the project. Moreover, in the explanatory analysis we will emphasise factors which can be influenced by decision-makers, both at national (e.g. ministries), regional (counties) and local (municipalities) provider level. Using time series data it is also possible to evaluate the effects of reforms made (such as Norwegian Hospital reform in 2002) from an international perspective.

At third stage we will explore some critical (mainly register-based) quality and outcome indicators, which can as such be used to describe important aspects of performance in hospital care. These indicators may also help to evaluate and investigate whether differences in hospital efficiency can be explained by these factors, i.e. whether there is trade-off between efficiency and quality of care.