Development of quality of care indicators for Parkinson's disease

被引:37
作者
Cheng, EM
Siderowf, A
Swarztrauber, K
Eisa, M
Lee, M
Vickrey, BG
机构
[1] VA Greater Los Angeles Healthcare Syst, Parkinsons Dis Res Educ & Clin Ctr, Dept Neurol, Los Angeles, CA 90073 USA
[2] Philadelphia Vet Affairs Med Ctr, PADRECC, Philadelphia, PA USA
[3] Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA
[4] Oregon Hlth & Sci Univ, Vet Affairs Med Ctr, PADRECC, Portland, OR 97201 USA
[5] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA
[6] Yale Univ, Dept Neurol, New Haven, CT USA
[7] Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA
关键词
quality indicators; Parkinson's disease; quality of health care; health services research;
D O I
10.1002/mds.10664
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Parkinson's disease (PD) is a major cause of disability. To date, there have been no large-scale efforts to measure the quality of PD care because of a lack of quality indicators for conducting an explicit review of PD care processes. We present a set of quality indicators for PD care. Based on a structured review of the medical literature, 79 potential indicators were drafted. Through a two-round modified Delphi process, an expert panel of seven movement disorders specialists rated each indicator on criteria of validity, feasibility, impact on outcomes, room for improvement, and overall utility. Seventy-one quality indicators met validity and feasibility thresholds. Applying thresholds for impact on out-comes, room for improvement, and overall utility, a subset of 29 indicators was identified, spanning dopaminergic therapy, assessment of functional status, assessment and treatment of depression, coordination of care, and medication use. Multivariable analysis showed that overall utility ratings were driven by validity and impact on outcomes (P < 0.01). An expert panel can reach consensus on a set of highly rated quality indicators for PD care, which can be used to assess quality of PD care and guide the design of quality improvement projects. (C) 2003 Movement Disorder Society
引用
收藏
页码:136 / 150
页数:15
相关论文
共 39 条
[21]  
Institute of Medicine (US) Committee on Quality of Health Care in America, 2001, CROSSING QUALITY CHA
[22]  
*JOINT COMM ACCR H, 1997, NAT LIBR HEALTHC IND
[23]   CONSENSUS METHODS FOR MEDICAL AND HEALTH-SERVICES RESEARCH [J].
JONES, J ;
HUNTER, D .
BRITISH MEDICAL JOURNAL, 1995, 311 (7001) :376-380
[24]   Variations by specialty in physician ratings of the appropriateness and necessity of indications for procedures [J].
Kahan, JP ;
Park, RE ;
Leape, LL ;
Bernstein, SJ ;
Hilborne, LH ;
Parker, L ;
Kamberg, CJ ;
Ballard, DJ ;
Brook, RH .
MEDICAL CARE, 1996, 34 (06) :512-523
[25]  
LEVINE CB, 2001, DIAGNOSIS TREATMENT
[26]   THE FREQUENCY OF IDIOPATHIC PARKINSONS-DISEASE BY AGE, ETHNIC-GROUP, AND SEX IN NORTHERN MANHATTAN, 1988-1993 [J].
MAYEUX, R ;
MARDER, K ;
COTE, LJ ;
DENARO, J ;
HEMENEGILDO, N ;
MEJIA, H ;
TANG, MX ;
LANTIGUA, R ;
WILDER, D ;
GURLAND, B ;
HAUSER, A .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1995, 142 (08) :820-827
[27]   Practice parameter: Initiation of treatment for Parkinson's disease: An evidence-based review - Report of the quality standards subcommittee of the American Academy of Neurology [J].
Miyasaki, JM ;
Martin, W ;
Suchowersky, O ;
Weiner, WJ ;
Lang, AE .
NEUROLOGY, 2002, 58 (01) :11-17
[28]   What is appropriate care? [J].
Naylor, CD .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (26) :1918-1920
[29]   Methodology matters - VIII - Eliciting expert opinion using the Delphi technique: identifying performance indicators for cardiovascular disease [J].
Normand, SLT ;
McNeil, BJ ;
Peterson, LE ;
Palmer, RH .
INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, 1998, 10 (03) :247-260
[30]   Screening for depression in adults: A summary of the evidence for the US Preventive Services Task Force [J].
Pignone, MP ;
Gaynes, BN ;
Rushton, JL ;
Burchell, CM ;
Orleans, CT ;
Mulrow, CD ;
Lohr, KN .
ANNALS OF INTERNAL MEDICINE, 2002, 136 (10) :765-776