S Steinke1,2, F C Beikert1,3, A Langenbruch1, R Fölster-Holst4, J Ring5, J Schmitt6, T Werfel7, S Hintzen8, N Franzke9, M Augustin1. 1. Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany. 2. Department of Dermatology, University Hospital Münster, Münster, Germany. 3. Practice Dres. Büttner/Meewes/Faubel, Neumünster, Germany. 4. Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany. 5. Department of Dermatology and Allergy, Technical University Munich, Munich, Germany. 6. Center for Evidence-based Healthcare, University Hospital Carl Gustav Carus, Dresden, Germany. 7. Division of Immunodermatology and Allergy Research, Clinic for Dermatology, Allergology and Venerology, Hannover Medical School, Hannover, Germany. 8. Department of Dermatology, Bundeswehrkrankenhaus Berlin, Berlin, Germany. 9. Hautarztpraxis Braunschweig, Braunschweig, Germany.
Abstract
BACKGROUND: Quality indicators are essential tools for the assessment of health care, in particular for guideline-based procedures. OBJECTIVE: Development of a set of indicators for the evaluation of process and outcomes quality in atopic dermatitis (AD) care. Application of the indicators to a cross-sectional study and creation of a global process quality index. METHODS: An expert committee consisting of 10 members of the German guideline group on AD condensed potential quality indicators to a final set of 5 outcomes quality and 12 process quality indicators using a Delphi panel. The outcomes quality and 7 resp. 8 process quality indicators were retrospectively applied to a nationwide study on 1678 patients with atopic dermatitis (AtopicHealth). Each individual process quality indicator score was then summed up to a global index (ranges from 0 [no quality achieved] to 100 [full quality achieved]) displaying the quality of health care. RESULTS: In total, the global process quality index revealed a median value of 62.5 and did not or only slightly correlate to outcomes quality indicators like the median SCORing Atopic Dermatitis (SCORAD; rp = 0.08), Dermatology Life Quality Index (DLQI; rp = 0.256) and Patient Benefit Index (PBI; rp = -0.151). CONCLUSION: Process quality of AD care is moderate to good. The healthcare process quality index does not substantially correlate to the health status of AD patients measured by 5 different outcomes quality indicators. Further research should include the investigation of reliability, responsiveness and feasibility of the proposed quality indicators for AD.
BACKGROUND: Quality indicators are essential tools for the assessment of health care, in particular for guideline-based procedures. OBJECTIVE: Development of a set of indicators for the evaluation of process and outcomes quality in atopic dermatitis (AD) care. Application of the indicators to a cross-sectional study and creation of a global process quality index. METHODS: An expert committee consisting of 10 members of the German guideline group on AD condensed potential quality indicators to a final set of 5 outcomes quality and 12 process quality indicators using a Delphi panel. The outcomes quality and 7 resp. 8 process quality indicators were retrospectively applied to a nationwide study on 1678 patients with atopic dermatitis (AtopicHealth). Each individual process quality indicator score was then summed up to a global index (ranges from 0 [no quality achieved] to 100 [full quality achieved]) displaying the quality of health care. RESULTS: In total, the global process quality index revealed a median value of 62.5 and did not or only slightly correlate to outcomes quality indicators like the median SCORing Atopic Dermatitis (SCORAD; rp = 0.08), Dermatology Life Quality Index (DLQI; rp = 0.256) and Patient Benefit Index (PBI; rp = -0.151). CONCLUSION: Process quality of AD care is moderate to good. The healthcare process quality index does not substantially correlate to the health status of ADpatients measured by 5 different outcomes quality indicators. Further research should include the investigation of reliability, responsiveness and feasibility of the proposed quality indicators for AD.
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