Development of Quality Indicators for Women With Urinary Incontinence

被引：16

作者：

Anger, Jennifer T. ^{[1
,2
]}

Scott, Victoria C. S. ^{[2
]}

Kiyosaki, Krista ^{[3
]}

Khan, Aqsa A. ^{[1
]}

Weinberg, Avivah ^{[2
]}

Connor, Sarah E. ^{[2
]}

Roth, Carol P. ^{[4
]}

Wenger, Neil ^{[5
]}

Shekelle, Paul ^{[4
,5
,6
]}

Litwin, Mark S. ^{[2
,7
]}

机构：

[1] Cedars Sinai Med Ctr, Dept Surg, Div Urol, Los Angeles, CA 90048 USA

[2] Univ Calif Los Angeles, David Geffen Sch Med, Dept Urol, Los Angeles, CA 90095 USA

[3] Univ Hawaii, Sch Med, Honolulu, HI 96822 USA

[4] RAND Corp, Southern Calif Evidence Based Practice Ctr, Santa Monica, CA USA

[5] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA

[6] Greater West Los Angeles Med Ctr, Vet Adm, Los Angeles, CA USA

[7] Univ Calif Los Angeles, Sch Publ Hlth, Hlth Serv, Los Angeles, CA 90024 USA

来源：

NEUROUROLOGY AND URODYNAMICS | 2013年 / 32卷 / 08期

关键词：

outcomes; quality indicators; RAND appropriateness method; stress urinary incontinence; urge urinary incontinence; OF-CARE; TAPE PROCEDURES; METAANALYSIS; TRANSOBTURATOR; PERFORMANCE; TRIALS; PAY;

D O I：

10.1002/nau.22353

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

AimsTo develop a means to measure the quality of care provided to women treated for urinary incontinence (UI) through the development of quality-of-care indicators (QIs). MethodsWe performed an extensive literature review to develop a set of potential quality indicators for the management of UI. QIs were modeled after those previously described in the Assessing the Care of Vulnerable Elders (ACOVE) project. Nine experts ranked the indicators on a nine-point scale for both validity and feasibility. We analyzed preliminary rankings of each indicator using the RAND Appropriateness Method. A forum was then held in which each indicator was thoroughly discussed by the panelists as a group, after which the indicators were rated a second time individually using the same nine-point scale. ResultsQIs were developed that addressed screening, diagnosis, work-up, and both non-surgical and surgical management. Areas of controversy included whether routine screening for incontinence should be performed, whether urodynamics should be performed before non-surgical management is initiated, and whether cystoscopy should be part of the pre-operative work-up of uncomplicated stress incontinence. Following the expert panel discussion, 27 of 40 potential indicators were determined to be valid for UI with a median score of at least seven on a nine-point scale. ConclusionsWe identified 27 quality indicators for the care of women with UI. Once these QIs are pilot-tested for feasibility, they will be applied on a larger scale to measure the quality of care provided to women with UI in the United States. Neurourol. Urodynam. 32:1058-1063, 2013. (c) 2013 Wiley Periodicals, Inc.

引用

页码：1058 / 1063

页数：6

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