Quality Indicators for the Care of People with Intellectual Disability in Family Medicine in Slovenia: A Modified Delphi Study.

Abstract

Introduction: People with intellectual disability (ID) experience poorer health outcomes and shorter life expectancy than the general population-gaps that could be mitigated by high-quality healthcare. In Slovenia, there are no specific recommendations for this population. The aim of this study was to identify and validate quality indicators (QIs) for the care of people with ID in family medicine, to serve as recommendations for this population in Slovenia.

Methods: A three-round Delphi study was conducted with 15 national experts. An initial set of 44 indicators, derived from the literature, was presented, and panel members proposed eight additional indicators. In the first round, panel members rated the importance of each indicator. Based on feedback, the indicators were revised to separate importance from the implementation interval. In the second and third rounds, panel members rated importance and feasibility and selected the most appropriate time interval.

Results: A total of 33 indicators were validated. These indicators cover multiple aspects of healthcare, including lifestyle factors, lifestyle advice, clinical outcomes, ongoing care, preventive medicine, and administration. Of the original 44 indicators, 28 were confirmed (64%). Of the 8 indicators proposed by panel members, 5 were validated (62.5%). A total of 9 of the original indicators (20%) and 3 of the panel-proposed indicators (37.5%) were considered important but not feasible.

Conclusions: This three-round Delphi study successfully developed QIs for the care of people with ID in Slovenia. These QIs can be integrated directly into existing system structures. The study provides a set of indicators that can inform the development of a clinical checklist and serve as a practical tool for evaluating both organisational and clinical aspects of quality of care.