Accenture Citizen Experience Study Title of brochure ......Indeed, the 2010 Accenture Citizen Experience Study examines respondents' views about the quality of health care and government’s

Title of brochureAccenture Citizen Experience Study

Measuring People’s Impressions of Health Care

How do citizens rate the quality of health care in their countries? How do they view government’s role in supporting—and improving—health and health care? What government actions do individuals consider important to making improvements, and how do they rate government’s performance in carrying out those actions? Through this year’s Accenture Citizen Experience Study, we’re exploring those and other questions. This overview provides key findings from the 16 geographies we surveyed. To learn more, visit www.accenture.com/ACES.

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Executive summary 4Summaries by geography Australia 10

Brazil 12

Canada 14

France 16

Germany 18

HongKong 20

India 22

Ireland 24

Italy 26

Japan 28

Mexico 30

Norway 32

Singapore 34

Spain 36

UnitedKingdom 38

UnitedStates 40

Appendix 42 AbouttheAccenturePublicServiceValueGovernanceFramework 42

Researchapproach 43

TheAccentureInstituteforHealth&PublicServiceValuedesignedtheAccentureCitizenExperience

Studytogenerallyexplorerespondents’perceptionsoftheimportanceofgovernmentactioninhelping

improvethequalityoftheirhealthandhealthcare,andtheirexperienceofhowwellgovernmentis

performingassuch.Recognizingthateverygeographyhasuniquecultural,socioeconomicandother

characteristics,wedidnotdesignthesurveytocompareandcontrastperformancebycountryorby

region,andtheresultsandinformationprovidedhereinorotherwisearenotintendedandshouldnot

beusedforsuchpurposes.

Table of contents

Fromridingonmasstransitandstudyinginpublicschoolstopayingtaxesorreportingcrime,mostpeopleinteractwithgovernmentthroughthedeliveryanduseofpublicservices.Togaugesatisfactionwiththequalityoftheirservices,governmentandpublicservicesorganizationsroutinelyconductsurveys.Butsuchsurveysoftendonotfullyaddressthepotentialcomplexityintherelationshipsbetweenindividualsandtheirgovernments—ortheimpactofservicedeliveryonthoserelationships.

BackgroundTheAccentureInstituteforHealth&PublicServiceValue—whichwascreatedtopromotehighperformanceinthehealthcaresectorandinpublicservicedelivery,policymakingandgovernance—initiatedtheAccentureCitizenExperienceStudytohelpfillthatvoid.

Thefirststudymeasuredthelevelofconnectionandengagementthatrespondentsin13geographiesperceivewiththeirgovernmentasaconsequenceofhowwellpublicservicesweremeetingtheirexpectationsaroundimprovingthequalityoftheirlives.Forthesecondroundofresearch,weexpandedthestudyto16geographiesandnarrowedthefocustohealthandhealthcare.

ObjectivesIndeed,the2010AccentureCitizenExperienceStudyexaminesrespondents'viewsaboutthequalityofhealthcareandgovernment’sroleinimprovingit.Morespecifically,weexploretheperceptionsontheimportanceof16governmentactionstoimprovethequalityofhealthandhealthcare,aswellastheexperienceofhowwellgovernmentisperforminginrelationtoeach.TheseactionsmaptothefourcomponentsoftheAccenturePublicServiceValueGovernanceFramework:Outcomes,Balance,EngagementandAccountability.(Youcanreadmoreabouttheframeworkandthe16governmentactionsrelatedtohealthonpages7,8and9andonpages42and43.)

Key findingsAcrossthegeographiessurveyedinthisyear’sAccentureCitizenExperienceStudy,thereisgreatvariationnotonlyinhealthsystems,butalsointhesocial,culturalandeconomicfactorsthatdeterminepeople’shealthneedsandexpectationsofgovernment.Notsurprisingly,expectationsvaryconsiderably,withrespondentsinsomecountriesplacinghigherimportancethanothersongovernmentactiontoimprovehealthandhealthcare.Forexample,anaverageof41percentofrespondentsinHongKongratedall16governmentactionsasessentialorveryimportant.InJapan,theaveragewas50percent.Yet,inBrazilandMexico,amuchhigherproportionofrespondents—anaverageof87percentineachcountry—assignedhighimportanceratingstoallofthegovernmentactions.

Thoughexpectationsvary,thesurveysuggestsastrongconsensusamongrespondentsallovertheworldaboutwhattheywantfromtheirhealthsystem.Respondentsconsistentlyexpresseddesireforgovernmenttotakeactiontoensurethathealthservicesareeasilyaccessibletoeveryone.Intermsofimportance,theyprioritizetwoparticularaspectsoftheirrelationshipwithgovernment,bothofwhichrelatetotheBalancecomponentoftheframework.Itseemsthatpeoplearoundtheworldwantgovernmenttoensurethathealthservices:

•Helppeoplewhomayhavedifficultiesusinghealthcareservices—forexample,theelderly—togaineasieraccess,whichrankedasoneofthetopthreeactionsforgovernmentinall16geographies.

•Providefairandequalaccesstohealthservicesforeveryone,whichrankedasoneofthetopthreeactionsin11ofthe16geographies.

Acrossall16geographies,79percentand78percent,respectively,ofrespondentsvotedtheseactionsasessentialorveryimportantforgovernment.

RespondentswerealsoveryconcernedaboutAccountabilityinrelationtohealthservices—particularlytheneedforhealthorganizationstotakeprompt,effectiveactiontoresolveproblemsordifficultiesthatpatientsandthepublicexperience.Respondentsin10ofthe16geographiesrankedthisasoneofthetopthreeactionsforgovernment.Infact,75percentofrespondentsonaveragerateditasessentialorveryimportant—wellaboveanyotheraspectofAccountability.

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Executive summary

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Inanumberofgeographies,respondentscalledforgovernmenttotakestepstoreducehealthdisparitiesandcreateequalopportunitiesforgoodhealthoutcomes.Manyrespondentsplacedstrongimportanceontargetinghealthservicestopeoplewiththehighestlevelofneed—forinstance,thoseinlowersocioeconomicormarginalizedgroups.Acrossall16geographies,anaverageof73percentofrespondentsratedthisactionasessentialorveryimportant,anditwasrankedoneofthetopthreeactionsinfivegeographies.

Othergovernmentactionsreceivedmoremixedsupport.Forexample,72percentofallrespondentsratedprovidingaclear,easywayforpeopletoaccesshealthinformationandinformationonhealthservicesasessentialorveryimportant.YetrespondentsinIndiawerealoneinselectingitasoneoftheirtopthreeactionsforgovernment.Similarly,71percentofallrespondentssupportafocusonprovidingreliableandtrustworthyinformationandadviceabouthealthandhealthservices—butthisactionrankedinthetopthreeinonlythreecountries.

InBrazilandMexico,respondentscalledformoreactionfromgovernmenttoencourageandeducatepeopletotakemorepersonalresponsibilityforimprovingtheirownhealthandthatoftheirfamilies.Morethan90percentofrespondentsratedthisactionasessentialorveryimportant,makingitoneofthetoptwoactionsineachcountry.InMexico,respondentsalsowantgovernmenttoensuremoreaccountabilityforthequalityofhealthservices.Morethanninein10ratedcreatingregularopportunitiesforpatientsandthepublictotakepartindiscussionsaboutthequalityofhealthservicesasessentialorveryimportant—thesinglemostimportantactionforgovernmentinthatcountry.

Respondents consistently expressed desire for government to take action to ensure that health services are easily accessible to everyone.

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Onlytwocountries,BrazilandIreland,prioritizedtheneedforgovernmenttoensurethathealthservicesdeliverrealimprovementsintheoverallhealthofthenation.While70percentofrespondentsratedthisessentialorveryimportant,itwasperceivedasbeinglessimportantthanothergovernmentactionsinmostgeographies.Thisresultsuggeststhatalthoughpeoplevaluebroaderpublichealthoutcomes,theyaremoreconcernedabouthavingaccesstohealthservicesforthemselvesandtheirfamiliesandensuringthateveryonehasthesameopportunitiestoaccessgood-qualityhealthserviceswhentheyneedthem.

Inassessingperformance,respondentsgenerallyagreedontheareaswheregovernmentisweakest.Inparticular,respondentsgavegovernmentthelowestmarksononeaspectofAccountability:ensuringthathealthorganizationscreateregularopportunitiesforpatientsandthepublictotakepartindiscussionsaboutthequalityofhealthservices.In15of16geographies,respondentsrankedthisactionasoneofthetwoareasinwhichgovernmentperformanceisweakest.TheotherareaofconsistentweaknessfallswithintheEngagementcomponent:seekingpeople'sviewswhendecidingontheprioritiesforhealthservices.Respondentsin10ofthe16geographiesviewthisactionasoneofthetwoinwhichgovernmentisperformingleastwell.Inbothcases,just21percentofrespondentsratedgovernmentperformanceasveryorfairlygood.

RespondentsalsoviewgovernmentperformanceasrelativelyweakinanotheraspectofAccountability:ensuringthathealthorganizationsprovideclearexplanationsofhowspendingprioritiesonhealthservicesaredecided.Respondentsperceivethatthedecisionsthataremadeinmanaginghealthcaresystemsshouldbemoretransparenttothepublic.

Perhapsmosttelling,though,istheextentofthe“gaps”thatexistacrosseachofthe16governmentactions.Theserepresentthedifferencebetweentheimportancerespondentsassigntoanactionandhowwelltheythinkgovernmentisperforminginrelationtoit.Innineofthe16geographies,respondentsidentifiedtakingprompt,effectiveactiontoresolveproblemsordifficultiesthatpatientsandthepublicexperiencewithhealthservicesastheactionwherethereisthelargestgapbetweentheimportancepeopleplaceongovernmentactionandgovernment’sperceivedperformance.Onaverage,75percentofrespondentsratethisasanessentialorveryimportantaction.Yetonly26percentthinkgovernmentisperformingwell.Inotherwords,almosthalfofallrespondentsbelievegovernmentperformanceisfallingshortinthisarea.

Otherareaswhererespondentsidentifysignificantgapsacrossthegeographiesareinhelpingpeoplewhomayhavedifficultiesusinghealthcareservices—forexample,theelderly—togaineasieraccess(anaveragegapof44percent),providingclearexplanationsofhowspendingprioritiesonhealthservicesaredecided(anaveragegapof43percent)andseekingpeople’sviewswhendecidingprioritiesforhealthservices(anaveragegapof42percent).

Forcitizensinall16geographies,accesstoservice,accountabilityandpublicengagementremainimportantchallengestotheirgovernmentandtheirhealthserviceorganizations.

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Outcomes AU BR CA FR DE HK IN IE IT JP MX NO SG ES UK US

Focusondeliveringrealimprovementsintheoverallhealthofthenation

3= 2=

Targethealthservicestohelppeoplewiththehighestlevelofneed

3= 2= 3 2= 3

Coordinatetheireffortswithdifferentpublicservices(e.g.,socialservices,schools)toensurethatpeople'swiderhealthneedsaremet

Coordinatetheireffortswithdifferentnongovernmentorganizationstoensurethatpeople'swiderhealthneedsaremet

BalanceProvidefairandequalaccesstohealthservicesforeveryoneinthecountry

2 1 1 1 2= 3 1 2 2 3= 2

Providepeoplewithtreatmentandcarethatismoretailoredtotheirindividualhealthneeds

3= 3 2 3 3=

Makehealthinformationandserviceseasilyavailabletopeoplethroughavarietyofdifferentmethods,suchastelephone,Internet,aswellasinperson

Helppeoplewhomayhavedifficultiesusinghealthcareservices,e.g.,theelderly,togaineasieraccess.

1 1 2= 2 2 1 2 1 1 2 2= 1 1 2 1 1

EngagementProvidereliableandtrustworthyinformationandadviceabouthealthandhealthservices

3 3= 2

Provideaclearandeasywayforpeopletoaccesshealthinformationandinformationonhealthservicesquicklyandeasily

1 3=

Seekpeople'sviewswhendecidingontheprioritiesforhealthservices

3

Encourageandeducatepeopletotakemorepersonalresponsibilityforimprovingtheirownhealthandthatoftheirfamilies

2 2=

AccountabilityProvideclearexplanationsofhowspendingprioritiesonhealthservicesaredecided

3=

Providethepublicandpatientswithclearevidenceofhowhealthcarepoliciesareimprovingpeople'shealth

Takepromptandeffectiveactiontoresolveproblemsordifficultiesthatpatientsandthepublicexperiencewithhealthservices

3 2= 3= 3 3 2= 3 3 1 3=

Createregularopportunitiesforpatientsandthepublictotakepartindiscussionsaboutthequalityofhealthservices

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At-a-glance: Top three government actions to help improve health and health care

Interpreting the findings Weaskedrespondentstothinkabout16governmentactions—eachrelatingtooneofthecomponentsoftheAccenturePublicServiceValueGovernanceFramework—thatshouldhelptoimprovehealthandhealthcareintheirgeographies.Morespecifically,weaskedrespondentstorateimportance—thatis,howcriticaleachactionshouldbe—andperformance—thatis,howwellgovernmentisperceivedtobedeliveringinthatarea.

Rating importanceFromthesurvey:“Thereareanumberofthingsthatthegovernmentcandotoensurethathealthservicesareprovidedinamannerthatwillhelpimprovepeople’shealth.Foreachofthefollowing,pleasetellushowimportantitisinimprovinghealthcareinyourcountry.Howimportantisitforgovernmenttoensurethathealthservices…?”

Respondentsratedimportanceonthisfive-pointscale:

1—Notatallimportant2—Notveryimportant3—Fairlyimportant4—Veryimportant5—Essential

Rating performanceFromthesurvey:“Wewillnowfocusonhowwellyouthinkthegovernmentisactuallyperformingonimprovinghealthcareinyourcountry.Foreachone,pleaseusethefollowingscaletotellushowwellthegovernmentisperforming.Basedonyourownpersonalexperience,howwellorpoorlydoyouthinkthegovernmentisperforminginthefollowingareas…?”

Respondentsratedperformanceonthisfive-pointscale:

1—Verypoorly2—Fairlypoorly3—Neitherwellnorpoorly4—Fairlywell5—Verywell

Tohelpsimplifythefindings,wecombinedthetoptworatingsoneachscale:“essential”and“veryimportant”forimportanceand“fairlywell”and“verywell”forperformance.Withasingleratingforimportanceandperformanceagainsteachaction,weprovidedavisualrepresentationofrespondents’ratings.Theresulting“radar”chartshelptoillustrategovernment’srelativestrengthandweaknessineachactionandacrosseachcomponentoftheframework.

Inthesectionthatfollows,wesummarizethemainfindingsforeachofthe16geographies.Withthedatafromthesurvey,governmentpolicymakers,healthleadersandotherstakeholderscanbetterunderstandrelativestrengthsandweaknessesandidentifykeyopportunitiesforimprovinglocalhealthandhealthservices.

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Outcomes1.Focusondeliveringrealimprovementsintheoverallhealthofthenation.2.Targethealthservicestohelppeoplewiththehighestlevelofneed.3.Coordinatetheireffortswithdifferentpublicservicestoensurethatpeople’swiderhealthneedsaremet.4.Coordinatetheireffortswithdifferentnongovernmentorganizationstoensurethatpeople’swiderhealthneedsaremet.

Balance5.Providefairandequalaccesstohealthservicesforeveryoneinthecountry.6.Providepeoplewithtreatmentandcarethatismoretailoredtotheirindividualhealthneeds.

7.Makehealthinformationandserviceseasilyavailabletopeoplethroughavarietyofdifferentmethods,suchastelephoneandInternet,aswellasinperson.8.Helppeoplewhomayhavedifficultiesusinghealthcareservices,e.g.,theelderly,togaineasieraccess.

Engagement9.Providereliableandtrustworthyinformationandadviceabouthealthandhealthservices.10.Provideaclearandeasywayforpeopletoaccesshealthinformationandinformationonhealthservicesquicklyandeasily.11.Seekpeople’sviewswhendecidingontheprioritiesforhealthservices.12.Encourageandeducatepeopletotakemorepersonalresponsibilityforimprovingtheirownhealthandthatoftheirfamilies.

Accountability13.Provideclearexplanationsofhowspendingprioritiesonhealthservicesaredecided.14.Providethepublicandpatientswithclearevidenceofhowhealthcarepoliciesareimprovingpeople’shealth.15.Takepromptandeffectiveactiontoresolveproblemsordifficultiesthatpatientsandthepublicexperiencewithhealthservices.16.Createregularopportunitiesforpatientsandthepublictotakeindiscussionsaboutthequalityofhealthservices.

Performance

Importance

Sample: Citizens’ perceptions on importance vs. performanceThisradarchartisgivenasanexampletoshowhowtoreadtheactualcharts.Thenumbersontheouteredgeofthecirclecorrespondtothenumberedactionsinthecopybelow.Pointsontheouterbluelineindicatetheimportanceofanactiontorespondents,whilepointsontheinnerredlineindicatetherespondents’perceptionofgovernmentperformance.Thedistancebetweenthetwolinesistheperformancegap,whichisthedifferencebetweenimportanceandperformance.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Accountability Outcomes

Engagement Balance

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Australia

Engagement•RespondentsinAustraliawantgovernmenttoprovidereliable,trustworthyinformationandadviceabouthealthandhealthservices.•Anotherpriorityisofferingaclear,easywayforrespondentstoaccesssuchinformation.•Justone-thirdofrespondentsthinkgovernmentisperformingwellintheseareas.

Accountability•Respondentsassignedlessimportancetothiscomponent;theyalsothinkgovernmentperformanceisweakestinthisarea.•Akeyactionistakingprompt,effectiveactiontoresolveproblemsordifficultiestheyexperiencewithhealthservices.•Yet,onlyoneinfivegiveafavorableratingtogovernmentperformance—representingthelargestgapbetweenimportanceandperformance,aswellasthegreatestopportunityforimprovement.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0


Engagement Balance

Australia: Respondents' perceptions of importance vs. performance

Performance

Importance

Australianrespondentsgenerallyhaveapositiveviewoftheircountry’shealthsystem.Sixty-ninepercentratethequalityofhealthcareinAustraliaasverygoodorfairlygood,whileonly15percentrateitaspoor.However,respondentsaredividedonwhetherornottheytrustgovernmenttohelpimprovethequalityofhealthservices.Morethanhalf(54percent)saytheyhavesomeoragreatdealoftrustingovernment,but43percentsaytheyhavelittleornotrustinthisregard.RespondentsperceivethemostimportantthinggovernmentshoulddotoimprovehealthcareinAustraliaistoincreasecapacityinthehealthsystem:81percentofrespondentscalledforgovernmenttoincreasethenumberofqualifiedmedicalprofessionals;79percentwouldliketoseeareductioninwaitingtimesfortreatments;and73percentprioritizedanincreaseinthenumberofhealthcarefacilitiestoensuremoreequalcoverageacrossthecountry.

Outcomes•Respondentswantgovernmenttofocusonprovidingrealimprovementsinthehealthofthenation.•Anothertoppriority:targetingservicestothosewiththegreatestneed.•Onlyaboutone-thirdofrespondentsthinkgovernmentisdoingwellinthesetwoareas.

Balance•RespondentsseeBalanceandEngagementasthetwomostimportantcomponentsofthegovernancerelationship.•Respondentsgavethegreatestweighttotwooftheactionswithinthiscomponent:helpingpeoplewhomayhavedifficultyusinghealthcareservices(suchastheelderly)togaineasieraccessandprovidingfair,equalaccesstohealthservicesforeveryone.•Almosthalfofrespondentsthinkgovernmentperformancefallsshortinbothareas.

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Overall, how would you rate the quality of health care in Australia?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in Australia?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

311

15

2843

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 10

3

12

15

18

51

20 30 40 6050

How important is it for government to take action in each of these areas to improve the quality of health care?

Percentage

0 10 20 30 40 6050

81

70 80 90

79

73

67

66

65

63

56

54

50

42

Increasethenumberofqualifiedmedicalprofessionals

Reducewaitingtimesfortreatments

IncreasethenumberofhealthfacilitiestoensuremoreequalcoveragearoundthecountryImproveavailabilityofexpensivedrugsandtreatmentsEnsurewiderchoiceoftreatmentandcareisavailable

Sethigherqualitystandardsforallhealthcareproviders

Putmoreemphasisonpreventativecare

Putmoreemphasisoneducatingpeopleaboutpublichealthissues

Maintainorenhanceeffortstotrackandcontainglobalhealthpandemics

GivepeoplegreatersayaboutthehealthservicesintheirlocalareaProvideinformationabouthowwelldifferenthealthprovidersareperforming

33 percent of respondents who thought three or more actions were essential or very important rated this as the most important action government could take to improve health care

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Outcomes•NinetypercentormoreofBraziliansemphasizedthreekeyactionswithinOutcomes.•Theygavetopprioritytodeliveringrealimprovementsintheoverallhealthofthenationandtargetinghealthservicestothosewiththegreatestneed.•Theyalsowantgovernmenttoensurethathealthproviderscoordinateeffortswithdifferentpublicservicestoensurethatrespondents’widerhealthneedsaremet.

Balance•Brazilianslaudedgovernmentwithtopmarksformakinghealthinformationandserviceseasilyavailablethroughavarietyofmethods.•Theygavepoormarkstogovernmentforhelpingrespondentswhomayhavedifficultiesusinghealthservicestogaineasieraccess,whichwasalsoperceivedasthemostimportantaction.

Engagement•AstrongmajorityofBrazilians(92percent)consideritessentialorveryimportantthatgovernmenteducaterespondentstotakemoreresponsibilityfortheirownhealth.•Braziliansalsoemphasizedtheneedforgovernmenttoprovideaclear,easywaytoaccesshealthinformationandinformationonhealthservices,aswellastoseekrespondents’viewswhensettingprioritiesforhealthservices.

Accountability•Onaverage,85percentofBraziliansratedAccountabilityactionsasessentialorveryimportant.•Thiscomponentofthegovernanceframeworkhasthesmallestaveragegapbetweenimportanceandperformance(36percent);however,gapsforthefourcomponentswererelativelyclose,withonlyathree-percentage-pointspreadbetweenthem.

BrazilBrazilianrespondentsperceivethequalityofhealthcareintheircountryaspoor:Almosttwo-thirds(64percent)ratehealthcarequalityasfairlyorverypoor.Indeed,morerespondentsratequalityasverypoor(30percent)thanrateitonanyscaleofgood(19percent).Overwhelmingly,respondentswantgovernmenttorespondtotheseperceivedqualityissuesbyplayingagreaterroleinallareasofhealthcare.Ninein10wantgovernmenttodomoretodeliverservicesdirectly(91percent)andtosetandmaintainqualitystandardsforproviders(90percent).Morethaneightin10alsowantgovernmenttodomoretopromotehealthyliving(84percent)andtorespondtohealthepidemics(80percent).Fromtheseresponses,itisclearthatrespondentsperceivegovernmentmusttakesignificantstepsifitistoaddresstheunsatisfactoryqualityofhealthcareinthecountry.

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3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Brazil: Respondents' perceptions of importance vs. performance

Performance

Importance


Engagement Balance

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InMexicoandBrazil,interviewswereconductedbytelephonetohelpensurethatwesurveyedamorerepresentativesampleofthepopulation.Weadaptedandshortenedthequestionnaireforthetelephoneaswehadlesstimetoadministerit.Assuch,someofthedatashownforMexicoandBrazilisdifferentfromthatoftheothercountriesinthesurvey,andthiswasfactoredintoouroverallassessment/conclusions.

How big of a role should government play in health care in Brazil?

Percentage0 10 6020 7030 8040 9050 100

Settingandmaintainingstandardsforhealthcareprovidersanddrugcompanies

Providinghealthservicesdirectlytopeopleinyourcountry

Promotinghealthyliving,e.g.,byencouragingpeopletostopsmokingortoimprovetheirdiet

Takingaleadinrespondingtohealthepidemics,e.g.,swineflu

Aboutthesamerole

Governmentshouldnothavearole

Moreofarole

Percentage

Lessofarole

90 8

1

3

1.5

91

84

80

8

13

17

1.5

Overall, how would you rate the quality of health care in Brazil?

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 5

30

34

17

1

18

10 20 30 40352515

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Canada

Balance•Canadianrespondentsratedthiscomponentasthemostimportantofthefour;anaverageofthree-quartersratedthesefouractionsasessentialorveryimportant.•Theyalsoindicatedthatgovernmentisstrongestinthisarea;onaverage,45percentofCanadianrespondentsratedgovernmentasperformingfairlyorverywellacrosseachoftheactions.

Engagement•CanadianrespondentsregardEngagementasbeingalmostasimportantasBalance.•Theyemphasizedgivingpeoplereliable,trustworthyinformationandadvice,aswellaseasyaccesstohealthinformationandinformationabouthealthservices.•Yet,fewerthanfourin10thinkgovernmentisdeliveringwellineitherofthoseareas.

Accountability•Ingeneral,Canadiansplacedlessemphasisonthiscomponentoftheframework.•However,80percentprioritizedtakingprompt,effectiveactiontoresolveproblemsthatpatientsandthepublicexperiencewithhealthservices.•Withafavorableperformanceratingofjust20percent,thatactionholdsthelargestgapbetweenimportanceandperformanceacrossallfourcomponents.

Canada: Respondents' perceptions of importance vs. performance

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89

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16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

AmajorityofrespondentsinCanadahaveapositiveviewofthequalityofhealthcareinthecountry.Seventy-eightpercentratethequalityofhealthcareasfairlyorverygood,whilejustninepercentratethequalityaspoor.Generally,theCanadianpublicsupportsthegovernmentandtrustsitsabilitytoimprovehealthcare.Fifty-sixpercenthavesomeoragreatdealoftrustingovernment,though27percentsaytheyhaveonlyalittletrustandaroundonein10(12percent)statethattheyhavenotrustatallingovernment.Canadiansidentifiedareasinwhichgovernmentneedstotakeaction.Inparticular,theycalledforimprovementstocapacityandaccessibilityofcarewithinthesystem.Three-quartersofrespondentswantgovernmenttotakestepstoreducewaitingtimesandtoincreasethenumberofqualifiedmedicalprofessionals(thelatterratedthemostimportantactionbyalmostfourin10respondents).Overhalf(55percent)perceivethereisaneedtoincreasethenumberofmedicalfacilitiestoensuremoreequalcoverageacrossCanada.Respondentsalsowantawiderchoiceoftreatmentandcare,aswellasimprovementsinavailabilityofdrugsandtreatmentsaspartofimprovedaccess.Almostsixin10Canadianscallongovernmenttosethigherqualitystandardsforhealthproviders.

Outcomes•Canadianrespondentsplacedthegreatestemphasisontargetinghealthservicestothosewiththehighestlevelofneeds.•Closebehind:focusingondeliveringrealimprovementsintheoverallhealthofthenation.•Onlybetween26percentand37percentofCanadianrespondentsgivefavorableratingstogovernmentperformancearoundOutcomes—representinganaveragegapbetweenimportanceandperformanceofjustover35percent.

Performance

Importance


Engagement Balance

15

Overall, how would you rate the quality of health care in Canada?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in Canada?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

115

12

2745

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 10

2

7

12

24

54

20 30 40 6050


Percentage

0 10 20 30 40 6050

75

70 80

75

61

59

59

55

53

49

47

43

43



Ensureawiderchoiceoftreatmentandcareisavailable


ImproveavailabilityofexpensivedrugsandtreatmentsIncreasethenumberofhealthfacilitiestoensuremoreequalcoveragearoundthecountry




Provideinformationabouthowwelldifferenthealthprovidersareperforming

Givepeopleagreatersayaboutthehealthservicesintheirlocalarea


16

France

Balance•TheFrenchrespondentsplacedthegreatestemphasisonthiscomponent.•Thetwomostimportantactions:providingfairandequalaccesstohealthservicesandhelpingpeoplewhomayhavedifficultyusingservices.•Thiscomponentreceivedthehighestratingsforgovernmentperformance;onaverage,32percentofrespondentsratedgovernmentasperformingfairlyorverywell.

Engagement•Engagementisthesecond-mostimportantcomponenttotheFrenchrespondents,andtheonlyoneinwhichasignificantmajorityratedeveryactionasessentialorveryimportant.•Yet,respondentsaregenerallynegativeaboutgovernmentperformancevis-à-vis thiscomponent;lessthanoneinfivethinkgovernmentisperformingwellinthisarea.

Accountability•TheFrenchrespondentsconsidergovernmentperformancetobeweakestaroundAccountability.•Thelargestgapsbetweenimportanceandperformanceareintakingprompt,effectiveactiontoresolveproblemsordifficultiesandinprovidingclearexplanationsofspendingpriorities.

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89

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16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

France: Respondents' perceptions of importance vs. performance

Overall,morethan80percentofrespondentsinFranceratethequalityofhealthcareasfairlygood(63percent)orverygood(18percent).Only3percentratethequalityofhealthcareasfairlypoor,andnoneperceivethequalityofhealthcareasverypoor.WhilerespondentsareverypositiveabouthealthcareinFrance,respondentsaresplitonwhetherornottheytrustgovernmenttoimprovethequalityofhealthservices.Forty-onepercentsaytheyhaveagreatdealorsometrustingovernment,butasmallmajority(53percent)saytheyhavelittleornotrustinthisregard.Respondentsperceivethemostimportantthinggovernmentcandotoimprovehealthcareistoimprovetheaccessibilityofhealthcareservicesandincreasethecapacityofthehealthsystem.Nearlythree-quartersofrespondentswouldlikegovernmenttoincreasethenumberofmedicalprofessionals(35percentofrespondentsselectedthisasthesinglemostimportantaction).Meanwhile,two-thirdswouldliketoseeareductioninwaitingtimesfortreatmentandanincreaseinthenumberofhealthcarefacilities.

Outcomes•Outcomesisthethird-mostimportantcomponent,with62percentratingtheseactionsasessentialorveryimportant.•Amajority(68percent)emphasizedtheneedforgovernmenttotargethealthservicestohelpthosewiththegreatestneed.•Similarly,67percentassignedimportancetocoordinatingeffortsacrossdifferentpublicservicesentities.

Performance

Importance


Engagement Balance

17

Overall, how would you rate the quality of health care in France?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in France?

Don'tknow/Prefernottoanswer

Noneatall

Percentage

Some

Agreatdeal

Alittle

6919

34

32

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 10

0

3

16

18

63

20 30 40 7050 60


Percentage

0 10 20 30 40 6050

73

70 80 90

66

63

63

61

57

53

47

45

44

36



IncreasethenumberofhealthfacilitiestoensuremoreequalcoveragearoundthecountryImproveavailabilityofexpensivedrugsandtreatments

SethigherqualitystandardsforallhealthcareprovidersEnsureawiderchoiceoftreatmentandcareisavailable







18

Germany

Balance•Almostsevenin10prioritizetheseactions—nearly10percentmorethananyoftheothercomponents.•Ofall16governmentactions,themostimportanttoGermanrespondentsareprovidingfairandequalaccesstohealthcareandhelpingthosewhomayhavedifficultyaccessingservices.•Thelargestgapbetweenimportanceandperformanceisinprovidingfairandequalaccess(55percent).

Engagement•ThetoppriorityforGermanrespondents:providingaclear,easywayforpeopletoaccesshealthinformationandinformationabouthealthservices,which66percentratedessentialorveryimportant.

•Followingclosely—with60percentratingitasessentialorveryimportant—isseekingpeople’sviewswhensettingpriorities.•Onlyaboutone-fifthgavefavorableratingstogovernmentperformanceinEngagement.

Accountability•Onaverage,55percentofGermanrespondentsratedAccountabilityactionsasessentialorveryimportant.•Onlyoneinsixrategovernmentasdoingfairlyorverywellagainstthoseactions.•Themostimportantactionisalsotheonewiththebiggestgapbetweenimportanceandperformance:takingprompt,effectiveactiontoresolveissuesthatpatientsandthepublicexperiencewithhealthservices.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Germany: Respondents' perceptions of importance vs. performance

RespondentsinGermanyareguardedlypositiveabouthealthcarequality.Themajority(56percent)perceivequalityinGermanyisgood,butonly9percentrateitasverygood.Meanwhile,16percentratequalityaspoor,and29percentasneithergoodnorpoor.Althoughtheseratingssuggestsignificantroomforimprovement,Germanrespondentsdonotexpressagreatdealoftrustingovernment’sabilitytodeliverrealimprovements.Sixtypercentstatethattheyhavelittleornotrustingovernment.Just5percenthaveagreatdealoftrust.Respondentsaredividedontheactionsgovernmentshouldtaketoimprovequality.Theygenerallysupportamixtureofmeasurestoimprovecapacityanddeliverbetterqualityandmorechoice.Suggestedactionstoimprovecapacityaddresssupply(increasingthenumberofqualifiedmedicalprofessionalsreceivedthegreatestsupportat56percent),aswellasdemand(53percentsupportgreateremphasisonpreventativecare).Thesamenumber(53percent)alsosupportsettinghigherqualitystandards,while49percentcalledforawiderchoiceoftreatmentstobemadeavailable.

Outcomes•Onaverage,about60percentofrespondentsratedtheseactionsasessentialorveryimportant.•Germanrespondentsassignedgreatestimportancetocoordinatingeffortswithdifferentpublicservicestohelpmeetpeople’swiderhealthneeds.•OnlyaroundoneinfiveratedgovernmentperformancefavorablyinrelationtoOutcomes—indicatinganaveragegapbetweenimportanceandperformanceof35percent.

Performance

Importance


Engagement Balance

19

Overall, how would you rate the quality of health care in Germany?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in Germany?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

65

2934

26

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 10

3

13

29

9

47

20 30 40 50


Percentage

0 10 20 30 40 6050

56

53

53

49

47

42

42

41

41

40

38




Ensurewiderchoiceoftreatmentandcareisavailable



Givepeoplegreatersayaboutthehealthservicesintheirlocalarea


ImproveavailabilityofexpensivedrugsandtreatmentsPutmoreemphasisoneducatingpeopleaboutpublichealthissues

Increasethenumberofhealthfacilitiestoensuremoreequalcoveragearoundthecountry


20

Balance•RespondentsinHongKongplacedthegreatestimportanceonthiscomponent.•Respondentsexpressedparticularconcernaboutequitableaccess,prioritizingprovisionoffairandequalaccessandhelpforthosewhomayhavedifficultiesingainingaccess.•Theyidentifiedthesmallestgapbetweenimportanceandperformancearoundmakinghealthinformationandservicesavailablethroughnumerouschannels.

Engagement•AlongwiththoseunderAccountability,Engagementactionsgarneredessentialorveryimportantratingsfromfewerthanhalfofrespondents.•Respondentsgaverelativeweighttoseekingpeople’sviewswhendecidinghealthprioritiesandprovidingaclear,easywaytoaccesshealthinformationandinformationonhealthservices.

Accountability•AlthoughAccountabilityreceivedrelativelylowaverageimportanceratings,thiscomponentcontainstwoofthetop-fiveconcernsamongrespondents.•Thefirstistakingprompt,effectiveactiontoresolveissuesthatpatientsandthepublicexperiencewithhealthservices.•Thesecondisprovidingclearexplanationsofhowspendingprioritiesaredecided.

Hong KongRespondentsinHongKongdidnotexpresssignificantconcernsaboutthequalityofhealthcareavailabletothem.Mostdonotconsiderhealthcarequalitytobepoor.Nordotheyrateitasgood.Infact,27percentratequalityasgoodand15percentaspoor,butamajority(57percent)rateitasneithergoodnorpoor.Evenso,mostrespondentsexpressacautiousoptimismaboutgovernment’sabilitytoeffectimprovementsinhealthcare.Fifty-ninepercentindicatethattheyhavesomeoragreatdealoftrustingovernmenttobringaboutimprovements;only11percenthavenotrustatall.However,thelevelofconfidenceisnotoverwhelming:76percentstatethattheyhaveonlysomeoralittletrustingovernment.Thereisagreementamongrespondentsabouttheactionstheyperceivegovernmentneedstotaketobringaboutimprovementsinhealthcare.Mostperceivethatcapacityiskey(twosupportedactionsareaimedatthisissue)andthatmoreneedstobedonetohelpensurestandardsandrespondtoglobalhealthissues.Sixty-twopercentwantgovernmenttoreducewaitingtimes;57percentwantanincreaseinthenumberofqualifiedmedicalprofessionals;53percentwantgovernmenttosetandmaintainhigherqualitystandards;and51percentwantgovernmenttomaintainorenhanceeffortstotrackandcontrolglobalhealthpandemics.

Outcomes•Outcomesisthesecond-mostimportantcomponent;morethanhalfofrespondentsprioritizedtheseactions.•Governmentperformanceisencouragingagainstthreeofthefouractions,withlowgapsbetweenimportanceandperformance.•Theexceptionistargetingservicestothosemostinneed;itsgapisnearlydoublethatoftheotherthreeOutcomesactions.

Hong Kong: Respondents' perceptions of importance vs. performance

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Performance

Importance


Engagement Balance

21

Overall, how would you rate the quality of health care in Hong Kong?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in Hong Kong?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

49

11

2650

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 10

2

13

57

2

25

20 30 40 6050


Percentage

0 10 20 30 40 6050

62

70

57

53

51

50

47

44

41

39

34





IncreasethenumberofhealthfacilitiestoensuremoreequalcoveragearoundthecountryEnsureawiderchoiceoftreatmentandcareisavailable


Improveavailabilityofexpensivedrugsandtreatments




22

IndiaIndianrespondentsaredividedintheirviewsofhealthcarequality.While44percentratequalityasveryorfairlygood,27percentrateitasfairlyorverypoor,and28percentasneithergoodnorpoor.Evenso,respondentsexpressagreatdealoftrustingovernmenttodeliverimprovementsinhealthcare.Sixty-threepercentstatedthattheyhavesomeoragreatdealoftrustingovernment.Just6percentindicatedthattheyhavenotrustingovernmenttodeliverimprovements.Respondentsarelessclearaboutwhatactionsneedtobetakentoimprovehealthcare.Themostpopularactionsfocusontacklingcapacityissuesbyincreasingcapacityorreducingdemand.Seventy-twopercentsupportincreasingthenumberofqualifiedmedicalprofessionals;71percentcalledforincreasingthenumberofhealthfacilities;71percentwouldlikemoreemphasisonpreventativecare;and69percentplacedmoreemphasisoneducatingrespondentsaboutpublichealthissues.

Outcomes•Aboutthree-quartersofrespondentsratedOutcomesactionsasessentialorveryimportant.•Seventy-sevenpercentprioritizedtargetinghealthservicestothosewiththegreatestneed.•IndianrespondentsassignedthesmallestgapbetweenimportanceandperformancetoanOutcomesaction:coordinatingeffortswithnongovernmentorganizationstoaddressrespondents’widerhealthneeds.

Balance•IndianrespondentsratedBalancesimilarlytoOutcomes,withaboutthree-quartersprioritizingtheseactions.•Inparticular,80percentofrespondentsconsideritimportantthatgovernmentassistthosewhomayhavedifficultiesaccessinghealthservices.•Nearlyasmany(78percent)prioritizedthefair,equalprovisionofservicestoeveryone.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

India: Respondents' perceptions of importance vs. performance

Performance

Importance


Engagement Balance

Engagement•Indianrespondentsratedthiscomponentasmostimportant.•Theyplacedspecialimportanceonprovidingaclear,easywayforrespondentstoaccesshealthinformationandhealthservices—selectingitasthemostimportantofall16actions.•Theyalsoprioritizedgovernmentprovidingreliable,trustworthyinformationandadviceabouthealthandhealthservices.

Accountability•Althoughrespondentsassignedthiscomponenttheleastimportance,sevenin10stillratetheseactionsasessentialorveryimportant.•Thiscomponentgarneredthelowestperformanceratings.•Indianrespondentsidentifiedthelargestgapbetweenimportanceandperformancearoundtakingprompt,effectiveactiontoresolveissuesforpatientsandthepublic.

AllinterviewsinIndiawereconductedonline.Consequently,theresponseprofileismoreheavilyskewedtowardthemoreeducatedandyoungeragegroups.

23

Overall, how would you rate the quality of health care in India?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in India?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

3

20

6

28

43

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 5

7

20

28

10

34

10 20 30 40352515


Percentage

0 10 20 30 40 6050

72

70 80

71

71

69

68

66

66

64

60

59

70




SethigherqualitystandardsforallhealthcareprovidersPutmoreemphasisoneducatingpeopleaboutpublichealthissuesEnsureawiderchoiceoftreatmentandcareisavailable







24

•Lessthanoneinfiveoftherespondentsstatedthatgovernmentisperformingwellineitheroftheseareas.•Governmentreceivedhighestmarksformakinghealthinformationandservicesavailablethroughavarietyofmethods,thoughstillonlyoneinfivethinkgovernmentisperformingwellinthisarea.

Engagement•Eighty-twopercentofIrishrespondentsemphasizedprovidingaclear,easywaytoaccessinformationandadviceabouthealthandhealthservices.•Thesecond-highestpriority:providingreliable,trustworthyinformationandadviceabouthealthandhealthservices.•Onaverage,actionswithinEngagementhaveagapofabout65percentbetweenimportanceandperformance.

Accountability•Takingprompt,effectiveactiontoresolveissuesforpatientsandthepublicwasoneofthetop-rankingactions;86percentofIrishrespondentsrateditessentialorveryimportant.•Yet,only11percentthinkgovernmentisperformingwellagainstthataction—representingagapof75percent.•Providingclearexplanationsofspendingprioritiesisalsoanareaofimportanceandrelativelypoorperformance,withagapofover70percent.

Ireland: Respondents' perceptions on importance vs. performanceIrelandIrishrespondentsaresomewhatdividedintheirviewsonhealthcarequality.Whilealmost40percentratethequalityaseitherfairlygood(33percent)orverygood(5percent),40percentratethequalityaspoor.Notsurprisingly,then,therespondentsappearedtolacktrustingovernmenttoimprovethequalityofhealthservices.SeventypercentofIrishrespondentssaidtheyhaveonlyalittletrustornotrustatallingovernment;just30percentsaidtheyhavesomeoragreatdealoftrust.RespondentsperceivethemostimportantthingsgovernmentshoulddotoimprovehealthcareinIrelandaretoreducewaitingtimesfortreatments(85percent),sethigherqualitystandardsforhealthcareproviders(79percent)andincreasethenumberofhealthcarefacilitiestoensuremoreequalcoverageacrossthecountry(73percent).Respondentsalsoperceivethatthereshouldbeawiderchoiceoftreatmentandcareavailableandthatthegovernmentshouldputmoreemphasisonpreventativecare,suchasregularhealthcheckupsandimmunizations(both72percent).

Outcomes•IrishrespondentsassignedequalimportancetoOutcomesandBalance;onaverage,almosteightin10ratedgovernmentactionsintheseareasasessentialorveryimportant.•Inparticular,respondentswantgovernmenttofocusonprovidingrealimprovementsinthehealthofthenationandtotargethealthservicestothosewhoneedthemmost.•However,only16percentofrespondentsthinkgovernmentisperformingwellinthoseareas.

Balance•Respondentsassignedgreatimportancetotwoactions:helpingthosewhomayhavedifficultiestogaineasieraccesstoservicesandprovidingfairandequalaccesstohealthservicesforeveryoneinIreland.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Performance

Importance


Engagement Balance

25

Overall, how would you rate the quality of health care in Ireland?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in Ireland?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

5

2538

32

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 5

10

30

22

5

33

10 15 20 3525



SethigherqualitystandardsforallhealthcareprovidersIncreasethenumberofhealthfacilitiestoensuremoreequalcoveragearoundthecountry










30

Percentage

0 10 20 30 40 6050

85

70 80 90

79

73

72

72

70

69

58

58

57

56

26

Italy

•Thetwomostimportantactions:helpingrespondentswhomayhavedifficultiestogaineasieraccess(78percent)andprovidingtreatmentandcarethatismoretailoredtorespondents’individualneeds(72percent).•Thoughthiscomponentreceivedthehighestperformanceratings,italsoexhibitsthehighestaverageperformancegap.

Engagement•Respondentsprioritizedprovidingaclear,easywayforrespondentstoaccesshealthinformationandinformationabouthealthservices.•TogetherwiththoseofAccountability,Engagementactionsreceivedthelowestperformanceratings.•Only15percentratedgovernmentasperformingveryorfairlywellinseekingrespondents’viewswhendecidingprioritiesforhealthservices.

Accountability•Accountabilityrankedastheleastimportantofthefourcomponents,with56percentonaverageratingtheseactionsasessentialorveryimportant.•Themostimportantaction:takingprompt,effectiveactiontoresolveproblemsordifficultiesthatpatientsandthepublicexperience.•Withinthiscomponent,thatactionalsoexhibitedthegreatestgapbetweenimportanceandperformance(66percent).

Italy: Respondents' perceptions of importance vs. performance

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

ItalianrespondentsaredividedintheiropinionofthequalityofhealthcareinItaly.Asignificantnumber(43percent)perceivehealthcareasgood,butone-quarterrateitaspoorandthreein10(31percent)areuncertain,ratingitneithergoodnorpoor.Respondentsarealsosomewhatskepticalaboutgovernment’sabilitytoimprovehealthcare.Sixin10statetheyhavelittleornotrustingovernmenttomakeimprovements,whilelessthanone-third(30percent)havesomeoragreatdealoftrust.Nevertheless,respondentsperceivestronglythatgovernmentneedstotakeactiontoimproveaccess.Nearlyeightin10(78percent)identifiedreducingwaitingtimesasoneofthethreemostimportantactions,andmorethansixin10(65percent)wantbetteravailabilityofexpensivedrugsandtreatmentsandawiderchoiceoftreatments(60percent).Halfofrespondentsalsoperceivegovernmentneedstoimprovecapacityinthesystembyincreasingthenumberofqualifiedmedicalprofessionals(52percent)andthenumberofmedicalfacilities(49percent).

Outcomes•Outcomesisthesecond-mostimportantcomponent,withanaverageof65percentratingtheseactionsasessentialorveryimportant.•Inparticular,respondentsemphasizedgovernmenttargetingservicestothosemostinneed,aswellascoordinatingeffortsacrosspublicservicestoaddresswiderhealthneeds.•Onlyaboutone-quartergavegovernmentfavorableperformanceratingsagainsttheseactions.

Balance•Italianrespondentsconsiderthisthemostimportantcomponentoftheirrelationshipwithgovernment.

Performance

Importance


Engagement Balance

27

Overall, how would you rate the quality of health care in Italy?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in Italy?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

12 10

25

35

18

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 10

6

19

31

4

39

20 30 40 50


Percentage

0 10 20 30 40 6050

78

70 80 90

68

65

60

55

52

50

49

49

48

46







ProvideinformationabouthowwelldifferenthealthprovidersareperformingPutmoreemphasisoneducatingpeopleaboutpublichealthissues





28

Balance•TheJapaneserespondentsselectedBalanceasthemostimportantcomponentoftheirrelationshipwithgovernment.•It’stheonlycomponentforwhichmorethanhalfofrespondents,onaverage,ratedthefouractionsasessentialorveryimportant.•Respondentsseemakinghealthinformationandserviceseasilyavailablethroughavarietyofmethodsastheareawhereperformancemostcloselyalignswithimportance.

Engagement•Respondentsplacedthemostimportanceonavailabilityofinformation.•Thetwomostcriticalactionsareprovidingaclear,easywayforpeopletoaccesshealthinformationandinformationabouthealthservicesandprovidingreliable,trustworthyinformationandadviceabouthealthandhealthservices.

•Theactionwiththesmallestgapbetweenimportanceandperformance(just6percent):encouragingandeducatingpeopletotakemorepersonalresponsibilityfortheirhealth.

Accountability•Thisisthesecond-mostimportantcomponent,trailingBalancebyasignificantmargin.•Accountabilityincludesanaction(oneofonlythreeacrossallcomponents)thatmorethanhalfofrespondentsprioritized:takingprompt,effectiveactiontoresolveissuesforpatientsandthepublic.•Thegapissmallestforcreatingregularopportunitiesforpeopletotakepartindiscussionsaboutthequalityofhealthservices.

Japan: Respondents' perceptions of importance vs. performanceJapanJapaneserespondentsaredividedintheirperceptionsofthequalityofhealthcare.Almosthalf(48percent)ratequalityasfairlyorverygood,butmostarenotoverwhelminglypositive.Just6percentratequalityasverygood.Only15percentratequalityasfairlyorverypoor,butthevastmajorityratequalityinthemiddleoftherange.Infact,88percentrateitaseitherfairlygood,neithergoodnorpoororfairlypoor.Generally,respondentsexpressahighleveloftrustingovernmenttodriveimprovementsinhealthcare.Sixty-onepercentstatethattheyhavesomeoragreatdealoftrustingovernment’sabilitytobringaboutimprovement.Just12percentstatedtheyhavenotrustatallingovernment,andonly19percenthavealittletrust.Respondentsidentifiedarangeofactionstheyperceivegovernmentshouldtaketoimprovethehealthcaresystem.Themostimportantactionstheyidentifiedfocusonarangeofissues,includingcapacity,choiceandmanagingglobalhealthissues.Fifty-twopercentperceiveincreasingthenumberofqualifiedmedicalprofessionalsisimportant;49percentwantgovernmenttomaintainorenhanceeffortstotrackandcontainglobalhealthpandemics;and47percentwanttoseeawiderchoiceoftreatmentandcareoptions.

Outcomes•FortheJapaneserespondents,thiscomponentgarneredthelowestaverageimportancescore;just35percentratedtheactionsasessentialorveryimportant.•Respondentsassignedthemthelowestgapbetweenimportanceandperformanceatjust13percent.•Respondentsplacedthegreatestemphasisontargetinghealthservicestothosewiththemostneed.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Performance

Importance


Engagement Balance

29

Overall, how would you rate the quality of health care in Japan?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in Japan?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

85

12

1956

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 10

2

13

33

6

42

20 30 40 50














Percentage

0 10 20 30 40 6050

52

49

47

42

41

41

39

35

35

30

25

30

Outcomes•MexicanrespondentsregardOutcomesandEngagementasequallyimportantcomponents.•WithinOutcomes,theyplacedthemostimportanceontargetinghealthservicestothosewiththemostneed.•At49percentto55percent,thegapbetweenimportanceandgovernmentperformanceisfairlyconsistentacrossallfouractions.

Balance•ForrespondentsinMexico,Balanceisthemostimportantcomponentoftheirrelationshipwithgovernment.•Theyemphasizedhelpingthosewhomayhavetroubleaccessingservices,with90percentratingthisactionasessentialorveryimportant.•Similarly,88percentassignedimportancetogovernmentensuringthathealthservicesprovidecaremoretailoredtoindividualneeds.

Engagement•Aclearmajorityemphasizedencouragingandeducatingrespondentstotakemoreresponsibilityfortheirownhealth;90percentrateditasessentialorveryimportant.•Thatactionisalsotheonewiththegreatestgapbetweenimportanceandperformance(48percent).•Morethan80percentofrespondentsalsoprioritizedtheotherthreeEngagementactions.

Accountability•Onaverage,Accountabilityistheleastimportantcomponent.•Evenso,itincludesthemostimportantaction—andtheonewiththebiggestgapbetweenimportanceandperformance—acrossallcomponents:creatingregularopportunitiesforpatientsandthepublictotakepartindiscussionsabouthealthservices.•Theactionwiththesmallestgapisprovidingclearevidenceofhowhealthpoliciesareimprovingrespondents’health.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Mexico: Respondents' perceptions of importance vs. performanceMexicoMexicanrespondentsdonothaveaparticularlypositiveviewofhealthcarequality.Although36percentrateitasgood,56percentrateitasfairlyorverypoor,withsignificantlymore(21percent)ratingqualityasverypoorthanratingitasverygood(6percent).Mexicanrespondentswantgovernmenttorespondtotheperceivedqualityissuesbyplayingagreaterroleinanumberofareas.Almostninein10(88percent)wantgovernmenttoplayamoresignificantroleindirectlydeliveringhealthcareservicestorespondents;86percentwantgovernmenttodomoretosetandmaintainqualitystandards;86percentwantittoplayagreaterroleinpromotinghealthyliving;and81percentwantittoplayagreaterroleinleadingtheresponsetohealthepidemics.

Performance

Importance


Engagement Balance

31

How big of a role should government play in health care in Mexico?

Percentage0 10 6020 7030 8040 9050 100

InMexicoandBrazil,interviewswereconductedbytelephonetohelpensurethatwesurveyedamorerepresentativesampleofthepopulation.Weadaptedandshortenedthequestionnaireforthetelephoneaswehadlesstimetoadministerit.Assuch,someofthedatashownforMexicoandBrazilisdifferentfromthatoftheothercountriesinthesurvey,andthiswasfactoredintoouroverallassessment/conclusions.

Settingandmaintainingstandardsforhealthcareprovidersanddrugcompanies

Providinghealthservicesdirectlytopeopleinyourcountry

Promotinghealthyliving,e.g.,byencouragingpeopletostopsmokingortoimprovetheirdiet

Takingaleadinrespondingtohealthepidemics,e.g.,swineflu

Aboutthesamerole

Governmentshouldnothavearole

Moreofarole

Percentage

Lessofarole

386 10 1

4

5

5

88

86

81

8

7

13

2

1

Overall, how would you rate the quality of health care in Mexico?

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 5

21

34

7

6

30

10 20 30 40352515

32

Balance•NorwegianrespondentsselectedBalanceasthemostimportantcomponentbyasignificantmargin.•They’reespeciallyconcernedwithrespondentshavingequitableaccesstohealthcare;morethaneightin10ratedtheactionsrelatedtofairnessandequalityasessentialorveryimportant.•InBalance,thelargestgapbetweenimportanceandperformance(66percent)isaroundhelpingthosewhomayhavedifficultiestogaineasieraccesstocare.

Engagement•Onaverage,two-thirdsofNorwegianrespondentsratedEngagementactionsasessentialorveryimportant.•Respondentsparticularlyemphasizedtheimportanceofhavingeasyaccesstoreliableinformationabouthealthandhealthservices.•Theactionwhereimportanceandperformancearemostcloselyalignedisaroundencouragingandeducatingrespondentstotakemorepersonalresponsibilityfortheirhealth.

Accountability•Thiscomponentreceivedtheleastemphasis.•It’salsotheonewiththeweakestperformanceratingsforgovernment.•EightypercentofNorwegianrespondentsplacedimportanceontakingprompt,effectiveactiontoresolveissuesforpatientsandthepublic,butonlyoneinfivethinkgovernmentisperformingwellinthisarea.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Norway: Respondents' perceptions of importance vs. performanceNorwayNorwegianrespondentsareextremelypositiveabouttheirhealthcaresystem.Two-thirds(68percent)perceivethequalityofhealthcaretobefairlyorverygood,whilejust12percentrateitasfairlyorverypoor.RespondentsinNorwaylargelytrusttheirgovernmenttodeliverimprovementsinthequalityofhealthservices.Amajority(57percent)statetheyhavesomeoragreatdealoftrustingovernment.Meanwhile,21percentindicatethattheyhavealittletrust,andjust14percentsaytheyhavenotrustingovernment.ThoughNorwegianrespondentsgenerallyperceivethequalityofcareisgood,theyidentifiedsomethingstheyperceivegovernmentshoulddotodeliverimprovements.Themostimportantactionsallfocusonincreasingcapacity;75percentwouldliketoseeareductioninwaitingtimesfortreatment,and64percentperceivethereisaneedtoemploymoremedicalprofessionals.Fifty-sevenpercentwouldalsolikegovernmenttoensuregreaterchoiceinthetreatmentandcareavailabletothem.

Outcomes•Withinthisthird-rankedcomponent,almost80percentofNorwegianrespondentsgavehighestprioritytotargetinghealthservicestohelpthosewiththemostneed.•Sixty-ninepercentassignedimportancetogovernmentensuringhealthproviderscoordinateeffortswithdifferentpublicservicestoaddressrespondents’widerhealthneeds.•Thegapbetweenimportanceandperformanceissmallestforcoordinatingeffortswithnongovernmentorganizations.

Performance

Importance


Engagement Balance

33

Overall, how would you rate the quality of health care in Norway?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in Norway?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

813

14

2144

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 10

2

10

20

17

51

20 30 40 6050


75

64

57

55

51

47

42

39

36

35

33




SethigherqualitystandardsforallhealthcareprovidersImproveavailabilityofexpensivedrugsandtreatments








Percentage

0 10 20 30 40 6050 70 80 90

34

Singapore

Balance•Onaverage,eightin10ratedtheseactionsasessentialorveryimportant—makingthisthemostimportantcomponenttoSingaporeanrespondents.•Theyalsogavegovernmentfavorableperformanceratings,resultinginanaveragegapbetweenimportanceandperformanceofjust16percent.•However,respondentsassignedheavyimportancetofairnessofaccess—theactionthatexhibitsthehighestgapacrossall16actions.

Engagement•RespondentsinSingaporearemostconcernedwithgovernmentprovidingreliable,trustworthyadviceandinformation.•Ingeneral,theyratedgovernmentperformancefavorablyacrossaspectsofEngagement,withtheexceptionofseekingrespondents’viewswhendecidingprioritiesforhealthservices.•Thesmallestgapisineducatingandencouragingrespondentstotakepersonalresponsibility.

Accountability•Thoughratedtheleastimportant,AccountabilityisstillimportantforrespondentsinSingapore.•Respondentsespeciallyvalueprompt,effectiveactiontoresolveproblemsthatpatientsandthepublicexperiencewithhealthservices.•Theyconsiderthelargestgapbetweenimportanceandperformancetobearoundprovidingclearexplanationsonhowhealthprioritiesareset.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Singapore: Respondents' perceptions of importance vs. performance

Singaporeanrespondentsareextremelypositiveaboutthequalityofhealthcareintheircountry.Almostninein10(87percent)ratequalityasfairlyorverygood;just3percentrateitaspoor.Singaporeanrespondentsalsotrustgovernmenttomakeimprovementsinhealthcare.Almostninein10(86percent)havesomeoragreatdealoftrustingovernment’sabilitytodeliverimprovements.Eightpercentreporthavingalittletrust,andonly1percentsaytheyhavenoneatall.Comparedtorespondentsinothercountries,Singaporeanrespondentsexpressedoverwhelminglevelsofconfidence.Nevertheless,respondentslooktogovernmenttotakeactionstoimprovecapacityandchoicewithinthesystemandtoensurethathigh-qualitystandardsaremaintained.Three-quarters(76percent)identifiedreducingwaitingtimesasoneofthethreekeyactionsforgovernment.Theyalsoidentifiedincreasingthenumbersofmedicalprofessionals(71percent)andhealthfacilities(66percent)ascriticalactionsforimprovingcapacity.Alongsidethesecapacitymeasures,respondentswantgovernmenttoensureawidechoiceoftreatment(70percent).Thoughtheyarehappywiththequalityofcare,theyseesettingandmaintaininghigherqualitystandards(74percent)andrespondingtoglobalhealthpandemics(67percent)asessentialactionsindrivingfurtherimprovements.

Outcomes•Singaporeanrespondentsemphasizedtheneedtotargetservicestorespondentswiththegreatestneeds.•Alsoimportant:focusingondeliveringrealimprovementsinthehealthofthenation.•Two-thirdsofrespondentsperceiveperformanceagainsttheOutcomesactionsisgood—reflectingrelativelysmallgapsbetweenimportanceandperformance.

Performance

Importance


Engagement Balance

35

Overall, how would you rate the quality of health care in Singapore?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in Singapore?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

1

85

37

49

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 10

1

2

10

37

50

20 30 40 6050








IncreasethenumberofhealthfacilitiestoensuremoreequalcoveragearoundthecountryPutmoreemphasisoneducatingpeopleaboutpublichealthissues





Percentage

0 10 20 30 40 6050

76

70 80 90

74

71

70

67

67

66

61

60

54

49

36

Balance•Onaverage,three-quartersofSpanishrespondentsprioritizetheactionswithinBalance—makingitthemostimportantcomponentforrespondents.•Inparticular,respondentsareconcernedwithgovernmentimprovingaccesstohealthcareservices.•Onlyaroundhalfofrespondentsthinkgovernmentisperformingwellinthisregard.

Engagement•Morethansevenin10ratedEngagementactionsasessentialorveryimportant,makingitthesecond-mostimportantcomponent.•Spanishrespondentsassignedgreatimportancetogovernmentprovidingeasyaccesstoreliableinformationonhealthandhealthservices.•TheygavethetopratingforimportanceandperformancetothesameEngagementaction:providingaclear,easywayforrespondentstoaccesshealthinformationandinformationonhealthservices.

Accountability•Accountabilityrankedastheleastimportantcomponentoverall.•However,oneofitsactions—takingprompt,effectiveactiontoresolveissuesforpatientsandthepublic—wasrankedthemostimportantacrossall16actions.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Spain: Respondents' perceptions of importance vs. performanceSpainSpanishrespondentsaregenerallypositiveaboutthequalityofhealthcaretheyreceive.Amajorityofrespondents(58percent)ratequalityasfairlyorverygood.Bycontrast,18percentrateitasfairlypoorandjust4percentasverypoor.However,respondentsaredividedonthematteroftrustingovernmenttoeffectrealimprovementsinhealthcare.Slightlylessthanhalf(46percent)havesomeoragreatdealoftrustingovernment;50percenthavelittleornotrust.Indeed,thosewithnotrust(16percent)outnumberthosewithagreatdealoftrust(10percent).Butthereissignificantagreementovertheactionsrequiredtoimprovehealthcare.Morethanhalfofrespondentssupportallofthetopnineactions,withcapacityandavailabilityissuesbeingthemostimportant.Eighty-fourpercentwanttoseeareductioninwaitingtimes,79percentanincreaseinthenumberofqualifiedmedicalprofessionals,74percentimprovedavailabilityofexpensivedrugsandtreatmentsand72percentanincreaseinthenumberofhealthfacilities.

Outcomes•SpanishrespondentsrankedOutcomesasthethird-mostimportantcomponent.•Themostimportantactionisforgovernmenttoensurethathealthservicescoordinateeffortswithdifferentpublicservicestoaddresswiderhealthneeds.•ThisisalsotheOutcomesactionwiththegreatestperformancegap(32percent).

Performance

Importance


Engagement Balance

37

Overall, how would you rate the quality of health care in Spain?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in Spain?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

41016

34

36

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage0 10

4

18

21

18

40

20 30 40 50





IncreasethenumberofhealthfacilitiestoensuremoreequalcoveragearoundthecountryEnsureawiderchoiceoftreatmentandcareisavailable








84

79

74

72

67

67

60

60

53

46

43

Percentage

0 10 20 30 40 6050 70 80 90

38

United Kingdom

Balance•Byfar,Balanceisthemostimportantcomponent,withmorethanthree-quartersonaverageratingitsactionsasessentialorveryimportant.•RespondentsintheUnitedKingdomemphasizedfairandequitableaccesstohealthservicesandhelpingrespondentswhomayhavedifficultiesaccessinghealthservices.•TheyalsogavegovernmenttopmarksforperformanceinBalance—particularlyformakinginformationandservicesavailablethroughvariousmethods.

Engagement•Respondentsplacedthegreatestemphasisonprovidingreliable,trustworthyinformationabouthealthandhealthservices.•Theyalsoprioritizedgovernmentprovisionofclear,easywaysforrespondentstoaccesshealthinformationandinformationabouthealthservices.

Accountability•Accountabilityreceivedthelowestimportanceratingoverall.•However,morethanthree-quartersofUKrespondentsprioritizedgovernmenttakingprompt,effectiveactiontoresolveproblemsforpatientsandthepublic.•Theyalsoassignedthelargestgapbetweenperformanceandimportancetothataction—indicatingthegreatestopportunityforimprovement.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

United Kingdom: Respondents' perceptions of importance vs. performance

RespondentsintheUnitedKingdomarepositiveabouthealthcarequality.Morethanthree-quarters(79percent)rateitasfairlyorverygoodandjust10percentasfairlyorverypoor.However,opinionsaremuchmoremixedwhenitcomestotrustingovernment’sabilitytodeliverimprovements.Opinionisdividedevenly,withhalfhavinglittleornotrustingovernmentand48percenthavingsomeoragreatdealoftrust.However,almostthreetimesmorehavenotrustingovernment(23percent)thanhaveagreatdealoftrust(8percent).Despiterelativelyfavorableperceptionsofhealthcarequality,UKrespondentsstronglyperceivegovernmentactionsareneededtoimprovethesystem.Theyareparticularlykeenforgovernmenttosethigherqualitystandardsforproviders(77percent)andtoincreasecapacitytoreducewaitingtimes(63percent).Otherkeyactionsincludeanincreaseinthenumberofqualifiedmedicalprofessionals(71percent)andhealthfacilities(61percent).

Outcomes•Respondentsrankedthisastheleastimportantcomponent.•However,morethanhalfstillprioritizedallfouractionswithinit.•Inparticular,respondentsconsideritimportantforgovernmenttotargethealthservicestothosemostinneedandtofocusondeliveringrealimprovementsinthehealthofthenation.

Performance

Importance


Engagement Balance

39

Overall, how would you rate the quality of health care in the United Kingdom?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in the United Kingdom?

Agreatdeal

Don'tknow

Noneatall

Percentage

Some

Alittle

28

23

27

40


Percentage

0 10 20 30 40 6050

77

70 80 90

71

63

61

60

60

58

49

47

41

35






ImproveavailabilityofexpensivedrugsandtreatmentsEnsureawiderchoiceoftreatmentandcareisavailable






Percentage

60

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

0 10

2

8

11

26

53

20 30 40 50

40

United States

Balance•USrespondentsassignedthemostemphasistogovernmentensuringthatsupportisprovidedtorespondentswhomayhavedifficultiessotheycangaineasieraccesstocare.•Yet,onlyaboutoneinfivethinkgovernmentisperformingthatactionwell.

Engagement•USrespondentsidentifiedEngagementasthemostimportantcomponentoftheirrelationshipwithgovernment.•Morethansixin10rateeachoftheactionsasessentialorveryimportant.•However,governmentisfallingshortinanumberofareas—especiallyseekingrespondents’viewswhendeterminingprioritiesforhealthandhealthservices.

Accountability•USrespondentsperceivegovernmentperformanceisweakestinthiscomponent.•Theyplacedheavyemphasisongovernmentprovidingclearexplanationsofhowspendingprioritiesaredetermined.•Theyalsocalledforgovernmenttoprovideevidenceofhowhealthcarepoliciesareimprovingrespondents’healthandtotakeprompt,effectiveactiontoresolveissuesthatrespondentsexperiencewithhealthservices.

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16100- 90- 80- 70- 60- 50- 40- 30- 20- 10- 0

Performance

Importance

United States: Respondents' perceptions of importance vs. performance

AlthoughmorethanhalfofUSrespondents(55percent)ratethequalityofhealthcareasgood,25percentrateitaspoor,andUSrespondentsgenerallyappeardisengagedanddisappointedovereffortstoimprovehealthcare.Thepublicisdividedonwhetherornottheytrustgovernmenttoimprovethequalityofhealthservices;50percentsaytheyhavelittleornotrustinthisregard,while41percentsaytheyhavesomeoragreatdealoftrustingovernment.USrespondentsattachhighprioritytogovernmenttakingeffectiveactiontosolvethecountry’shealthcarechallenges,inspiteofthewidespreadlackoftrustingovernment’sabilitytodoso.Respondentsexpectgovernmenttotakeafirmroleinregulatinghealthprovidersandhealthinsurers.Inparticular,theywantgovernmenttoreformthehealthinsurancesystemtomakesuremedicalcareandhealthinsuranceareaffordableforeveryone(62percent).Indeed,fourin10rankedthisasthemostimportantaction.Inaddition,USrespondentswantgovernmenttointroduceprogramstopreventfraudandabusebyhealthcareproviders(69percent)andtosetminimumqualitystandardsforhealthproviders(63percent).

Outcomes•Onaverage,justundersixin10USrespondentsratedOutcomesactionsasessentialorveryimportant.•Theyplacedthemostimportanceongovernmentensuringthathealthproviderscoordinateeffortswithdifferentpublicservicestoaddresswiderhealthneeds.•ThatisalsotheOutcomesactionwiththelargestperformancegap.


Engagement Balance

41

910

27

23

31

Overall, how would you rate the quality of health care in the United States?

Taking everything into consideration, how much trust do you have in the government to improve the quality of health services in the United States?

Agreatdeal

Don'tknow/Prefernottoanswer

Noneatall

Percentage

Some

Alittle

Verygood

Fairlygood

Neithergoodnorpoor

Fairlypoor

Verypoor

Percentage

0 5

35

10 15 20 30 3525

20

18

17

8


69

70


Percentage0 10 20 30 40 6050

63

62

62

59

55

54

53

50

50

49

44

43

34

Introduceprogramstopreventfraudandabusebyhealthcareproviders

Setminimumqualitystandardsforallhealthcareproviders

ReformthehealthinsurancesystemtomakesuremedicalcareandhealthinsuranceareaffordableforeveryoneEnsurethateveryonecanhaveaccesstohealthcare


Givepeoplegreatersayaboutthehealthservicesintheirlocalarea


Provideinformationtoinformpeoplehowwelldifferenthealthprovidersareperforming




Introduceprogramstotacklecriticalpublichealthissues

Increasethenumberofhealthfacilitiestoensuremoreequalaccessaroundthecountry

Introducenewcomputersystemsasameansofimprovingdeliveryofservices

42

AppendixAbout the Accenture Public Service Value Governance Framework

GovernmentAnygovernmentorpublicserviceorganizationatthelocal,state/provincialornationallevel.

Public Service ValueTheoutcomesandresultsthatgovernmentandpublicserviceorganizationsproduceforthepeopletheyserve;thepublic-sectorequivalentofshareholdervalue.

Citizen, Service User, TaxpayerThethreerolesthroughwhichindividualsinteractwithgovernmentandpublicserviceorganizations.

TheAccenturePublicServiceValueGovernanceFrameworkprovidesanewmodelformorepubliclyengagedgovernance.Theframeworkisbuiltaroundfourcomponents:Outcomes,Balance,EngagementandAccountability.Forthisyear’sAccentureCitizenExperienceSurvey,wesuggest16governmentactionsrelatedtohelpingimprovehealthandhealthcare—fourforeachcomponent:

Outcomes—Focusing on helping improve social and economic outcomes•Focusondeliveringrealimprovementsinthe

overallhealthofthenation.•Coordinatetheireffortswithdifferentpublic

servicestoensurethatpeople'swiderhealthneedsaremet.

•Targethealthservicestohelppeoplewiththehighestlevelofneed.

•Coordinatetheireffortswithdifferentnongovernmentorganizationstoensurethatpeople'swiderhealthneedsaremet.

Balance—Balancing choice and flexibility with fairness and common good•Providefairandequalaccesstohealth

servicesforeveryoneinthecountry.•Makehealthinformationandserviceseasily

availabletopeoplethroughavarietyofdifferentmethods,suchastelephoneandInternet,aswellasinperson.

•Providepeoplewithtreatmentandcarethatismoretailoredtotheirindividualhealthneeds.

•Helppeoplewhomayhavedifficultiesusinghealthcareservices,e.g.,theelderly,togaineasieraccess.

Engagement—Engaging, educating and enrolling the public as co-producers of public value•Providereliableandtrustworthyinformation

andadviceabouthealthandhealthservices.•Seekpeople'sviewswhendecidingonthe

prioritiesforhealthservices.

•Provideaclearandeasywayforpeopletoaccesshealthinformationandinformationonhealthservicesquicklyandeasily.

•Encourageandeducatepeopletotakemorepersonalresponsibilityforimprovingtheirownhealthandthatoftheirfamilies.

Accountability—Clarifying accountability and providing clear avenues for public recourse•Provideclearexplanationsofhowspending

prioritiesonhealthservicesaredecidedon.•Takepromptandeffectiveactiontoresolve

problemsordifficultiesthatpatientsandthepublicexperiencewithhealthservices.

•Providethepublicandpatientswithclearevidenceofhowhealthcarepoliciesareimprovingpeople'shealth.

•Createregularopportunitiesforpatientsandthepublictotakepartindiscussionsaboutthequalityofhealthservices.

Government Citizen Service User Taxpayer

Outco

mes Balance

Accountability Enga

gemen

t

Public Service Value

43

Research approachForthisyear’sstudy,theAccentureInstituteforHealth&PublicServiceValue(workingwithIpsosMORI)surveyedmorethan16,000peopleofthegeneraladultpopulationsof16geographies:Australia,Brazil*,Canada,France,Germany,HongKong,India,Ireland*,Italy,Japan,Mexico,Norway*,Singapore,Spain,theUnitedKingdomandtheUnitedStates(seechart).

Weweightedthedatawiththeintenttoberepresentativeofthegeneralpopulationsofresidentsaged18orolder,withtheexceptionofIndia.(Indiadatawasweightedtoberepresentativeoftheonlinepopulationofresidentsaged18orolder.)WeconductedinterviewsbetweenDecember2009andFebruary2010.Weconductedmostinterviewsonline,withtheexceptionofBrazilandMexicowhereweconductedinterviewsbytelephonetogainrepresentativesamples.

Inadditiontoaskingrespondentstoratetheimportanceandperformanceof16governmentactions,wealsoaskedfortheirperspectivesonsomeotheraspectsofhealthandhealthcare,includingthequalityofhealthcareinthecountry,theirtrustingovernmenttoimprovethequalityofhealthservicesandactionsgovernmentshouldtaketoimprovehealthcare.

Recognizingthateverygeographyhasuniquecultural,socioeconomicandothercharacteristics,wedidnotdesignthesurveyinstrumenttocompareandcontrastperformancebycountryorbyregion,andtheresultsarenotintendedforsuchpurposes.

*Notincludedinthe2008survey.The2008AccentureCitizenExperienceStudycovered13geographies,exploringrespondents’perspectivesontheAccenturePublicServiceValueGovernanceFrameworkasitappliestoallpublicservices.

Sample Size by Country Total

Australia 1,017

Brazil 1,004

Canada 1,035

France 1,006

Germany 1,001

HongKong 1,007

India 1,009

Ireland 1,011

Italy 1,018

Japan 1,004

Mexico 1,022

Norway 1,001

Singapore 1,008

Spain 1,004

UnitedKingdom 1,010

UnitedStates 1,019

Total 16,176

Copyright©2010AccentureAllrightsreserved.

Accenture,itslogo,andHighPerformanceDeliveredaretrademarksofAccenture.

About AccentureAccentureisaglobalmanagementconsulting,technologyservicesandoutsourcingcompany,withmorethan181,000peopleservingclientsinmorethan120countries.Combiningunparalleledexperience,comprehensivecapabilitiesacrossallindustriesandbusinessfunctions,andextensiveresearchontheworld’smostsuccessfulcompanies,Accenturecollaborateswithclientstohelpthembecomehigh-performancebusinessesandgovernments.ThecompanygeneratednetrevenuesofUS$21.58billionforthefiscalyearendedAugust31,2009.Itshomepageiswww.accenture.com.

About the Accenture Innovation Center for HealthTheAccentureInnovationCenterforHealthprovidesinnovativeresourcesandrecommendedactionsforachievinghighperformanceinthehealthcareindustry.TheCenter,partoftheAccentureInstituteforHealth&PublicServiceValue,producesindustry-leadingwhitepapersandhostsengagingclientworkshopsandroundtablediscussions.TheAccentureInnovationCenterforHealth,combinedwithAccenture'sdeephealthindustryexperience,offersexceptionalreach,speedandflexibilitytohelpclientsachievehighperformance.Itshomepageiswww.accenture.com/innovationcenterforhealth.

About the Accenture Institute for Health & Public Service ValueTheAccentureInstituteforHealth&PublicServiceValueisdedicatedtopromotinghighperformanceinthehealthcaresectorandinpublicservicedelivery,policy-makingandgovernance.Throughresearchanddevelopmentinitiatives,theInstituteaimstohelphealthcareandpublicserviceorganizationsdeliverbettersocial,economicandhealthoutcomesforthepeopletheyserve.Itshomepageiswww.accenture.com/healthpublicservicevalue.

Documents

Accenture Citizen Experience Study Title of brochure ......Indeed, the 2010 Accenture Citizen Experience Study examines respondents' views about the quality of health care and government’s