Corso, Barbara

Luzi, Daniela

Minicuci, Nadia

Pecoraro, Fabrizio

Rocco, Ilaria

Tamburis, Oscar

Luzi Daniela

Pecoraro Fabrizio

Tamburis Oscar

Rocco Ilaria

Corso Barbara

Minicuci Nadia

Archivio della ricerca - Università degli studi di Napoli Federico II

Child asthma treatment: a comparison of 30 EU andEEA countries based on a business model DescriptionDaniela LuziD LuziNational Research Council, Rome, ItalyContact: d.luzi@irpps.cnr.itBackgroundAsthma is one on the most common chronic disease inchildhood. Its diagnosis and treatment is commonly based onthe GINA guidelines. However, differences across countries canbe detected in the access of services, coordination of healthcareprofessionals, provision of diagnostics tests, just to mention afew examples. For these reasons, the MOCHA project identifiedasthma as one of the tracing conditions to be analysed for thecomparison and appraisal of existing models of primary care forchildren among 30 EU/EEA countries. A business processmethodology is adopted providing the description of theorganization, coordination and delivery of childcare.MethodsA conceptual framework was developed to capture and singleout meaningful parts of the child healthcare pathways tofacilitate the comparison between national health systems. It isbased on UML (Unified Modelling Language) standard thatallows the description of childcare pathways considering:actors involved in the process of care; activities performed;services/locations of treatments, timelines. The processdescription is based on the results of Country Agentsquestionnaires developed by MOCHA partners around casestudies, that capture real-life context of childcare.ResultsOn the basis of results of the MOCHA questionnaires, UMLdiagrams are presented grouping countries similarities in terms ofprocedures, services, caregivers for asthma treatment. In parti-cular, the process description is focused on the access of out-of-hours services, use of medical records and performance of thespirometry test and referral procedures. This allows to capturepatterns of integration between primary and secondary care.ConclusionsThe process description approach allows the identification ofpatterns of healthcare delivery across countries. These resultswill be used in triangulation with the other MOCHA outputs,such as health outcomes, workforce and costs.How do European countries assess childcare? Acomparison of 30 EU and EEA countries in theMOCHA projectDaniela LuziD LuziNational Research Council, Rome, ItalyContact: d.luzi@irpps.cnr.itBackgroundThe assessment of childcare has to rely on a multidimensionalperspective to capture all the components that influence childwellbeing, enriching the Donabedian framework with mea-surements pertaining socio-economic, cultural and environ-mental aspects. Moreover, the introduction of patient-centredevaluations based on standardised validated instruments, suchas Patient Reported Outcome Measures (PROMs) and PatientReported Experience Measures (PREMs) provides new ways ofassessing quality of care.MethodsA questionnaire was developed and submitted to the MOCHAcountry agents to gather information on agencies performingassessment of quality of care as well as on the indicators usedto evaluate childcare, including the adoption of PREMs andPROMs. The results were analysed and classified according tothe Donabedian framework of structure, process and out-comes. Additionally, the classification also considers measuresrelated to health-related behaviour and socio-economic,cultural, and environmental determinants of health, that mapthe MOCHA conceptual model.ResultsThe majority of EU/EEA countries have national and/orregional agencies responsible for the evaluation of the qualityof care that includes in their assessment specific items related tochildcare. The analysis confirms that the majority of indicatorsused across countries concerns process measures. Results of thequanti-qualitative country distribution of indicators will bepresented as well as an analysis of the use of PROMs and PREMsadopted within the evaluation of childcare.ConclusionsThe analysis of quality measurements devoted to childcareallows us to map and gain a better insight into the coreindicators most frequently used across countries, identifyingbest practices as well as gaps in national evaluation of thedelivery of health services.Seeking a Holistic Matric of Strength of Primary Carefor ChildrenMichael RigbyM RigbyImperial College, London, UKContact: m.rigby@imperial.ac.ukThe Primary Health Care Activity Monitor for Europe(PHAMEU) project, a DG-Sanco funded project, led byNIVEL, created a measurement matrix to assess the strengthof primary. The rationale and methodology were sound androbust, but the PHAMEU matrix and its underpinningmeasures and values are generic, and thus based on the adultworld. In some European countries primary care for children isprovided by a quite separate system of provision from that foradults. In all countries the issues and values to ensure goodprimary care, not least access, continuity, and quality, are verydifferent when viewed through the lens of children’s needs,from infancy to adolescence.Hence the intent of the MOCHA project to produce ameasurement matrix for the Strength of Primary Care forChildren, distinct from yet inspired by the PHAMEU approachfor adults’ services.A systematic review of the literature has been carried out and acomposite model which is firmly based on the PHAMEU-Kringos framework has been adopted broadly measuringstructure, process and outcome. However, from a child centricperspective, a number of elements require further refinementwhich is being tested through a modified Delphi approachwith stakeholders. This will explore features such as thepresence of distinct and purposeful child policy, economiclevers, workforce, preventive care, access and equity coordina-tion and integration, advocacy and empowerment as well asspecific child health outcomes.This workshop will explore elements in the emergent frame-work, which will have separate measures by age-group 0-4years, 5-9 years, and 10-18 years, as well as an aggregateassessment. It is envisaged that the matrix will record 5measures against each of 10 characteristics, with separatemeasures for each age-group. It will seek to ensure acomparable measurement across all 30 different and disparateEuropean countries.10th European Public Health Conference: Parallel sessions 299Downloaded from https://academic.oup.com/eurpub/article-abstract/27/suppl_3/ckx187.803/4556764by gueston 04 November 2017

How do European countries assess childcare? A comparison of 30 EU and EEA countries in the MOCHA project

https://www.iris.unina.it/retrieve/handle/11588/740595/231288/ckx187.803.pdf

How do European countries assess childcare? A comparison of 30 EU and EEA countries in the MOCHA project

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Archivio della ricerca - Università degli studi di Napoli Federico II