The Commonwealth Fund's International Working Group on Quality Indicators, directed by Gerard F. Anderson of Johns Hopkins University and Robin Osborn, was organized in 1999 to develop a common set of minimum quality indicators for use in cross-national comparisons of health systems. Recognizing that national indicators such as life expectancy and infant mortality are greatly influenced by factors outside a country's health system, the working group seeks to recommend measures that will provide greater insight into how a national health sector performs relative to those of other countries, and how policy and delivery system organization affect quality. An initial list of disease-specific indicators for cancer, diabetes, cardiovascular disease, organ transplants, mental health, and asthma has been developed, and work on broader measures of disparities and health system responsiveness are currently underway. A report to health ministers and senior government officials is scheduled for release in May 2004.
The working group is a unique model for collaboration and technical exchange in health policy between industrialized countries. The five countries represented are Australia, Canada, New Zealand, the United Kingdom, and the United States; also participating are the Organization for Economic Cooperation and Development (OECD) and the World Health Organization. In 2003, the OECD expanded the collaboration to include 20 countries through its International Healthcare Quality Indicators Project, cosponsored by The Commonwealth Fund and chaired by Arnold Epstein, M.D., of Harvard University School of Public Health, chair of the Fund's working group. Building on the working group's initial indicator set, the OECD project has identified five areas for additional indicator development: coronary heart disease, diabetes, mental health, primary/preventive care, and patient safety.