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Transforming the French Healthcare System : Toward a Patient Centric Approach

Transforming the French Healthcare System : Toward a Patient Centric Approach
 Francesca Colombo
Head of the Health Division at the Organisation for Economic Co-operation and Development

The French Healthcare system is starting an important transformation through the government’s "Ma Santé 2022" (My Health 2022) plan. This plan aims at placing the quality and relevance of care at the heart of organizations and practices. This measure is one of the key announcements of the healthcare system transformation strategy. Where does France stand compared to other OECD countries ?

The French Social Security Financing Bill, which will enable the financing of the government's “Ma Santé 2022” plan, announces the creation of a new indicator measuring the patient's experience of care. What do you think of this measure?

Health systems across OECD countries are under pressure to demonstrate their value for the people they serve. In a context of ageing populations and accelerating technological transformation, there is demand for more and more responsive care. But there is unfortunately ample evidence of waste in health systems: up to 20 % of health spending is ineffective at best, or even wasteful. Further, as of today, we are unable to measure to what extent health systems are truly delivering what people need. Key to making a much needed shift from health systems centred on care providers to health systems centred on people is our ability to address this measurement gap. This is why France’s commitment to measure more indicators on patient experiences and to utilise them systematically for improving health care quality and make health systems more responsive is a step in the right direction.

Where is France in relation to other OECD countries in terms of the implementation of concrete measures to assess the experience and quality of patient care?

France measures and reports internationally several indicators of quality, including on the safety and effectiveness of hospital services, avoidable hospital admissions for chronic conditions, cancer survival, and prescribing of antibiotics in primary care. France has in recent years also developed surveys measuring patient satisfaction, mainly in hospitals. It also participated in international surveys on patient experience. These surveys assess the health care received based on individual’s expectations on how health care should be provided, on things such as clarity of the explanation given by doctors and patient involvement in decisions about their care. For example, 84 % of patients report positive experiences in terms of time spent with an ambulatory care doctor in France, slightly above the average for 18 OECD countries. 

However, so far, measurement of patient-reported experience, as well as patient-reported outcomes such as quality of life, ability to function and leave a normal life, pain or depression, is not widespread, nor systematic.

How can france catch up ?

As other OECD countries, France needs to better assess to what extent health policies are on track to make health systems more people centred, and able to deliver good quality and experience of care.

The OECD has started a new initiative to help countries fill in this gap – the Patient-Reported Indicators Surveys (PaRIS) initiative. PaRIS helps countries accelerate the adoption and reporting of validated, standardised, internationally-comparable patient-reported measures in areas such as hip and knee surgery, breast cancer and mental health. As we currently lack measurement of primary care, in a context where a growing number of people with chronic conditions seek care in the community, PaRIS is also developing a new international survey focusing on patients with one or more chronic conditions, treated in primary or other ambulatory care. France will benefit from participating in PaRIS because this will provide systematic assessments of how the health system delivers good outcomes and experiences to those set to benefit from it.

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