Background: The Dutch National Health Care Institute (NHCI) assesses evidence on the effectiveness of interventions for the purpose of reimbursement decisions. It also hosts the national register of guidelines containing medical guidelines together with their relevant quality indicators. The choice of which quality indicators to register in connection to a guideline is based on consensus between representatives of patients, caregivers and healthcare insurance companies.
Objectives: This study aimed at researching a possible overlap between an intervention’s health outcomes as assessed in the context of reimbursement; the related outcomes for the targeted disease as published by ICHOM (www.ichom.org); and, the quality indicators as mentioned in the relevant guidelines. If an overlap could be established between these three resources this may offer future possibilities for synchronising activities between these different domains.
Methods: We searched for subjects that were described in all three resources and ended up with (interventions in the) domains of lung cancer, spinal hernia (lower back pain), and stroke (cerebrovascular accident).
Results: This initial inventory showed the biggest overlap between the reimbursement assessments and the outcome indicators in ICHOM that serve to increase the transparency of quality of care. The guidelines in the register seem to focus far less on outcome indicators and have many more indicators that relate to the process or structure, such as which types of treatments a care-provider carries out, which disciplines are involved, volume-indicators, waiting times, completeness of registration, etc.
Discussion: This inventory, although preliminary, does give rise to the question 'To what extent is it possible – and desirable – to encourage overlap? and may contribute to the discussion about structure and process indicators no longer being needed if a broad basis of support exists for flawless outcome indicators.