Health outcomes are changes in patients’ health that occur as a result of health care. They include clinical measures of treatment success such as mortality and survival, quality of life that is commonly monitored through care outcomes reported by patients (symptoms, pain, mobility, ability to perform daily activities, etc.).

In health care, these are institutions that, among other things, record excellent results in treatment outcomes in certain therapeutic areas. In Croatia, according to a recent Ipsos survey, 9 out of 10 citizens said they were willing to travel outside the place of residence for several hours to get better care in an institution that has better treatment results. Centers of excellence are just that – institutions that combine a high level of expertise of employees, as well as technology and other resources needed to treat a particular disease. This makes them desirable for a larger number of patients, to whom a multidisciplinary team specialized in a particular disease is dedicated, and based on further monitoring of treatment outcomes, health processes are further optimized and the quality of health care is raised.

Outcomes reported by patients are increasingly recognized as the most important indicator of treatment outcomes. If we want to provide services that meet the needs of patients, we must necessarily consult them on satisfaction with both the treatment process and health outcomes. Information of this kind is collected through surveys. Patient Reported Outcome Measures include treatment symptoms (e.g. pain and fatigue), and quality of life measured through functional abilities such as mobility, psychological state (anxiety, depression), ability to perform daily tasks, return to work etc. Patient Reported Experience Measures include patients’ attitudes about service availability, care coordination, satisfaction with information about diagnostic tests and procedures, and whether they felt involved in making treatment decisions.

In Croatia, as in the rest of Europe, citizens finance health care. As funders, but also as beneficiaries, they have the right to information about the treatment results they can expect if they need health care. Disclosure of outcome data can enhance administration accountability, encourage quality improvement, improve the health literacy of the population, and facilitate the choice of physicians or hospitals by patients. It can also enable the identification of places where insufficient quality care is provided, and initiate mechanisms to correct this.

The structure of health systems varies greatly from country to country, as do treatment guidelines (which do not exist in some countries), available therapies, and consequently both the quality and outcomes of treatment vary.

Monitoring health outcomes requires certain investments in health informatization. However, better availability of quality data on care and outcomes will allow for rationalization of treatment and focus on effective treatment methods, which should result in significant savings. For example, conservative OECD estimates say that up to 20% of health spending is wasted on less effective or even harmful therapies. In Croatia, this would amount to approximately HRK 5 billion per year.

The method of collecting data on outcomes has undergone a major change over the years. In the past, it has involved considerable administrative effort to record a large amount of patient data in a separate database. Today, due to computerization, most data is collected automatically with minimal involvement of doctors and nurses.
The effort that healthcare professionals invest in monitoring treatment outcomes is of immense importance, both for patients and institutions, and for healthcare professionals themselves. Monitoring outcomes provides a clearer insight into existing quality of the system, its parts and individual processes, and it is easier to start mechanisms to correct possible shortcomings.

Outcomes monitoring results can be used to optimize the treatment of new patients practically as soon as we start collecting them. The whole concept is dynamic and the basic idea is that the treatment is continuously adjusted and improved in accordance with the results and new possibilities.

Yes, some medicine could be removed from the list if it turns out that in real life they do not give the results predicted by clinical trials. The patient directly benefits from this, as his treatment will focus on the therapeutic options that show the best results.

The severity and complexity of the disease are taken into account in the analysis so as not to compare “pears” and “oranges”.