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© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)., Mental ill-health is increasingly recognized by policymakers for its significant human and economic toll. The main objective of this study is to capture patient-reported outcomes and experiences on mental health care in Portugal using methods developed for international benchmarking purposes, such as the OECD Patient-reported Indicators Surveys. The study included 397 participants, 247 (62.2%) women, divided into four age groups: ages 16-24 years, ages 25-44 years, ages 45-65 years, and ages 66 years or older. The data collection procedure and analysis followed the OECD PaRIS Mental Health Working Group 2021 protocol allowing subsequent comparability with data from other OECD member countries. Findings on the WHO-5 Well-Being Index showed that women manifest a lower score in well-being following mental health care services use. This finding may be, at least in part, explained by the study population (mental health services users), including individuals with clinical depression which is more frequently observed in women. In terms of the level of satisfaction with treatment (provided by nurses, doctors, phycologists, etc.) the response "Yes, definitely" varied from 67% of answers regarding "time spent by care providers", 76.3% "involvement in decisions" to 79.7% regarding "clarity of explanations" and 84.4% regarding the item courtesy and respect. This study shows the feasibility of implementing and using patient-reported metrics (PROM and PREM) in mental health services in Portugal. The study results generate useful clinical information to help meet the expectations and needs of patients, contributing to a continuous improvement of mental health community services.

Heute werden mehr Menschen in Langzeitpflegeeinrichtungen versorgt als je zuvor, darunter immer mehr Personen mit chronischen Krankheiten und Mehrfacherkrankungen. Diese Entwicklung durfte sich in Anbetracht der zunehmenden Bevolkerungsalterung im OECD-Raum fortsetzen. Die Kosten vermeidbarer Krankenhauseinweisungen aus Langzeitpflegeeinrichtungen beliefen sich 2016 auf knapp 18 Mrd. USD. Dies entspricht 2,5 % der Ausgaben fur die stationare Krankenhausversorgung bzw. 4,4 % der Ausgaben fur die Langzeitpflege. Forschungsarbeiten zeigen, dass mehr als die Halfte der unerwunschten Ereignisse in der Pflege und 40 % der Krankenhauseinweisungen aus Pflegeeinrichtungen vermeidbar sind. Den Grundursachen dieser Ereignisse kann durch bessere Pravention, Sicherheitsmasnahmen und Personalentwicklung – insbesondere im Hinblick auf den Kompetenzmix und die Ausbildung – begegnet werden. Durch gezielte Investitionen in Schlusselbereichen konnen signifikante Effekte erzielt und die wichtigsten Kostentreiber unerwunschter Ereignisse in der Langzeitpflege reduziert werden.

Health care settings are inherently hazardous places, with very unpredictable and complex working environments. These hazards and risks not only result in a range of injuries and ill-health among workers but also jeopardise the safety of patients. The COVID-19 crisis has amplified the importance of ensuring that the health care that is provided is safe—for patients and health workers alike. A sufficient, and capable, workforce, is the foundation of resilient systems. Policy makers need to focus now on how to build and support an appropriate workforce to respond to future shocks. This includes health workers beyond the hospital—including those in community, long-term, and primary care. The safety of both patients and health workers should be protected through appropriate mechanisms to ensure the safety of protective equipment and sufficient supplies, appropriate staffing levels, training and support at the workplace. These governance mechanisms are even more relevant when policy makers face trade-offs between health, safety and economic concerns.

BackgroundAchieving people-centred health care systems requires new and innovative strategies to capture information about whether, and to what degree, health care is successful in improving health from the perspective of the patient. Patient-reported outcome measures (PROMs) and Patient-reported experience measures (PREMs) can bring some of these new insights, and are increasingly used in research, clinical care, and policymaking.MethodsThis paper reflects the ongoing discussions and findings of the OECD PaRIS Working Group on Patient-reported Indicators for Mental Health Care.ResultsThe OECD has been measuring quality of care for mental health conditions over the last 14 years through the Health Care Quality and Outcomes (HCQO) program; nonetheless, information on how persons with mental health problems value the services they receive, and impact of the services, remains limited. As of 2018, a survey from the OECD showed that only five of the twelve countries surveyed (Australia, Israel, Netherlands, Sweden, United Kingdom) reported PROMs and PREMs collection on a regular basis in mental health settings. The paper details some of the challenges specific to the collection and use of PROMs and PREMs in mental health care, and examples from countries which have implemented comprehensive programmes to gather information about PROMs and PREMs for individuals receiving mental health services.ConclusionsGiven the health and economic impact of mental ill-health across all OECD countries, there is significant value to being able to assess the quality and outcomes of care in this area using internationally-comparable measures. Continued international harmonisation of PROMs and PREMs for mental health through international coordination is a key way to facilitate the sharing of national experiences, promote the use of PROMs and PREMs, and create meaningful indicators for national and international benchmarking.

Long-term care (LTC) institutions are now providing care to a greater number of people, and more residents with chronic conditions and multiple co-morbidities, than ever before. Trends suggest this strain will continue to increase as OECD populations continue to age. The total cost of avoidable admissions to hospitals from LTC facilities in 2016 was almost USD 18 Billion, equivalent to 2.5% of all spending on hospital inpatient care or 4.4% of all spending on LTC. Research shows that over half of the harm that occurs in LTC is preventable, and over 40% of admissions to hospitals from LTC are avoidable. The root causes of these events can be addressed through improved prevention and safety practices and workforce development—including skill-mix and education. Targeted investments in a number of key areas can have a significant impact by mitigating the main cost drivers of adverse events in LTC.

While health care quality has been improving on average in OECD members countries, patient safety remains a central priority for policy makers and health care leaders. A growing research body has found that PSC is associated with numerous positive outcomes, including improved health outcomes, improved patient experience, and organisational productivity and staff satisfaction. Tools to measure PSC have proliferated in recent decades and are now in wide-spread use. This report includes findings from OECD countries on the state of the art for measurement practices related to PSC. Overall, measurement of PSC is prevalent across OECD countries, though the application, purpose, and tools vary. International learning and benchmarking has significant potential for better understanding and improvement of patient safety and health care quality.