Development of a set of schizophrenia quality indicators for integrated care.

Epidemiologia e psichiatria sociale Pub Date : 2010-01-01 DOI:10.1017/s1121189x00001603

Stefan Weinmann, Christiane Roick, Luise Martin, Stefan Willich, Thomas Becker

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引用次数: 17

Abstract

Aim: We aimed at developing a prioritized set of quality indicators for schizophrenia care to be used for continuous quality monitoring. They should be evidence-based and rely on routine data.

Methods: A systematic literature search was performed to identify papers on validated quality indicators published between 1990 to April 2008 in MEDLINE, the Cochrane databases, EMBASE and PsycINFO. Databases of relevant national and international organizations were searched. Indicators were described with respect to meaningfulness, feasibility and actionability. A workshop with relevant stakeholders evaluated the measures through a structured consensus process.

Results: We identified 78 indicators through literature search and selected 22 quality indicators. Furthermore, 12 structural and case-mix indicators were choosen. Only five quality indicators were rated "essential indicators" (priority 1), 14 were rated "additional first choice" (priority 2), and three were rated as "additional second choice" (priority 3). Only four indicators assessed outcome quality. In the majority of indicators the evidence base supporting the indicator recommendation was weak. None of the selected indicators was validated in experimental studies.

Conclusions: Evidence and validation base played only a subordinate role for indicator prioritisation by stakeholders indicating that there are discrepancies between clinical questions and requirements in schizophrenia care and scientific research.

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制定一套精神分裂症综合护理质量指标。

目的:我们旨在制定一套优先的精神分裂症护理质量指标，用于持续质量监测。它们应该以证据为基础，并依赖于常规数据。方法:系统检索MEDLINE、Cochrane数据库、EMBASE和PsycINFO数据库1990年至2008年4月间发表的关于质量指标的论文。检索了有关国家和国际组织的数据库。介绍了有关意义、可行性和可操作性的指标。与相关利益攸关方举行的研讨会通过结构化的协商一致进程评估了这些措施。结果:通过文献检索，确定了78个质量指标，筛选出22个质量指标。此外，还选择了12个结构性和病例组合指标。只有5个质量指标被评为“基本指标”(优先级1)，14个被评为“额外的第一选择”(优先级2)，3个被评为“额外的第二选择”(优先级3)。只有4个指标评估结果质量。在大多数指标中，支持指标建议的证据基础薄弱。所选指标均未在实验研究中得到验证。结论:证据和验证基础对利益相关者的指标优先排序仅起从属作用，表明精神分裂症护理和科学研究的临床问题与要求存在差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Epidemiologia e psichiatria sociale

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