Evidence-based performance indicators of primary care for asthma: a modified RAND Appropriateness Method

被引:45
作者
To, Teresa [1 ,2 ,3 ]
Guttmann, Astrid [1 ,3 ]
Lougheed, M. Diane [4 ,5 ]
Gershon, Andrea S. [3 ]
Dell, Sharon D. [6 ,7 ]
Stanbrook, Matthew B. [8 ]
Wang, Chengning
McLimont, Susan
Vasilevska-Ristovska, Jovanka
Crighton, Eric J. [9 ]
Fisman, David N. [2 ]
机构
[1] Hosp Sick Children, Div Paediat Med, Toronto, ON M5G 1X8, Canada
[2] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada
[3] Inst Clin Evaluat Sci, Toronto, ON, Canada
[4] Queens Univ, Dept Med, Div Resp, Kingston, ON K7L 3N6, Canada
[5] Kingston Gen Hosp, Clin Res Ctr, Asthma Res Unit, Kingston, ON K7L 2V7, Canada
[6] Hosp Sick Children, Div Resp Med, Toronto, ON M5G 1X8, Canada
[7] Univ Toronto, Dept Paediat, Toronto, ON M5S 1A1, Canada
[8] Univ Hlth Network, Toronto Western Res Inst, Toronto, ON, Canada
[9] Univ Ottawa, Dept Geog, Ottawa, ON K1N 6N5, Canada
基金
加拿大健康研究院;
关键词
performance measure; quality of healthcare; primary healthcare; asthma; evidence-based medicine; QUALITY-OF-CARE; HEALTH-CARE; GUIDELINES;
D O I
10.1093/intqhc/mzq061
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
To develop evidence-based performance indicators that measure the quality of primary care for asthma. Cochrane Database of Systematic Reviews, MEDLINE, EMBASE and CINAHL for peer-reviewed articles published in 1998-2008 and five national/global asthma management guidelines. Articles with a focus on current asthma performance indicators recognized or used in community and primary care settings. Modified RAND Appropriateness Method was used. The work described herein was conducted in Canada in 2008. Five clinician experts conducted the systematic literature review. Asthma-specific performance indicators were developed and the strength of supporting evidence summarized. A survey was created and mailed to 17 expert panellists of various disciplines, asking them to rate each indicator using a 9-point Likert scale. Percentage distribution of the Likert scores were generated and given to the panellists before a face-to-face meeting, which was held to assess consensus. At the meeting, they ranked all indicators based on their reliability, validity, availability and feasibility. Literature search yielded 1228 articles, of which 135 were used to generate 45 performance indicators in five domains: access to care, clinical effectiveness, patient centeredness, system integration and coordination and patient safety. The top five ranked indicators were: Asthma Education from Certified Asthma Educator, Pulmonary Function Monitoring, Asthma Control Monitoring, Controller Medication Use and Asthma Control. The top 15 ranked indicators are recommended for implementation in primary care to measure asthma care delivery, respiratory health outcomes and establish benchmarks for optimal health service delivery over time and across populations.
引用
收藏
页码:476 / 485
页数:10
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