Development of quality of care indicators to support chronic disease management

作者：Beaulieu Marie Dominique^*; Pomey Marie Pascale; Del Grande Claudio; Cote Brigitte; Tremblay Eric; Ghorbel Monia; Phuong Hua

来源：Sante Publique, 2015, 27: S67-S75.

• Quality indicators
• Health care
• Chronic care model
• Disease management
• Practice guidelines
• Quality of health care

Introduction: This article presents the results of a project conducted by the Institut national d'excellence en sante et en services sociaux of Quebec to develop quality of care indicators for the management of six chronic illnesses.
Methods: Indicators were identified through literature searches and analysis of clinical practice guidelines (CPGs). Interdisciplinary expert panels assessed their validity and the strength of the evidence on which they were based. Representatives of patients (N = 19) and professionals (N = 29) were consulted on their relevance and acceptability. Indicators were categorized according to the Chronic Care Model (CCM).
Results: A total of 164 indicators were developed, 126 specific to the illnesses under study and 38 on processes and outcomes generic to the CCM. There was convergence between patients and professionals on the relevance of a majority of indicators. Professionals expressed concerns on the indicators measured by means of patient surveys that they considered to be too subjective.
Discussion: The importance given to CPGs as the main source of indicators resulted in a great number of indicators of the technical quality of care. Using the CCM contributed to a broader perspective of quality. The consultation process identified some of the concerns of professionals about indicator measurement, thus guiding future implementation initiatives.

• 出版日期2015-2