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Feasibility of 48 quality indicators in ambulatory care in Germany: a cross-sectional observational study.
Z Evid Fortbild Qual Gesundhwes. 2015; 109(9-10):682-94.ZE

Abstract

BACKGROUND

The National Association of Statutory Health Insurance Physicians develops quality indicators (QIs) for ambulatory care in Germany. This study explores the feasibility of a total of 48 QIs.

METHODS

Cross-sectional observational study with primary data collection in writing from medical practices in 10 specialist fields of outpatient care. "Feasibility" covers 7 criteria for indicator assessment and data collection: applicability, availability, retrievability, complexity, relevance, reliability, and acceptance. A questionnaire consisting of 10 questions was used to evaluate these feasibility criteria for each indicator. Survey results were subjected to descriptive analysis.

RESULTS

The analyzed sample comprises 103 participants who have been working as practice-based physicians for an average of 13 years. 40% only keep electronic medical records and 2% only paper records, and the rest uses both. The rating of QIs in the field-specific QI sets shows the following mean values: 67% of the participants consider the QIs assigned to them as corresponding to their practice care mandate. Data on these QIs deemed to be applicable are collected by 94% of respondents, documented by 91%, and by 51% electronically. 58% of the data required for the denominator, and 38% for the numerator are retrievable from the practice management system. The time required to access data on a QI is more than 30minutes for 84% of respondents, and 67% consider the effort involved as unacceptable. The rating received was 61% for the relevance of QIs to the assessment of a practitioner's own quality of health care, 69% for the estimated reliability of data collection, and 58% for the acceptance of being evaluated via QIs.

CONCLUSIONS

In order to improve the feasibility of QI-based practice assessments it will be necessary to a) fine-tune the selection of QIs for the respective groups of specialist, b) to promote the use of computerized practice management systems, and c) integrate effective and user-friendly retrieval functions in the software. Another aspect to be explored is how the acceptance of QI-based practice evaluations can be improved in individual specialist fields.

Authors+Show Affiliations

Institute for Health Systems Research, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany. Electronic address: Werner.deCruppe@uni-wh.de.National Association of Statutory Health Insurance Physicians, Berlin, Germany.National Association of Statutory Health Insurance Physicians, Berlin, Germany.National Association of Statutory Health Insurance Physicians, Berlin, Germany.Institute for Health Systems Research, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

26699257

Citation

de Cruppé, Werner, et al. "Feasibility of 48 Quality Indicators in Ambulatory Care in Germany: a Cross-sectional Observational Study." Zeitschrift Fur Evidenz, Fortbildung Und Qualitat Im Gesundheitswesen, vol. 109, no. 9-10, 2015, pp. 682-94.
de Cruppé W, Kleudgen S, Diel F, et al. Feasibility of 48 quality indicators in ambulatory care in Germany: a cross-sectional observational study. Z Evid Fortbild Qual Gesundhwes. 2015;109(9-10):682-94.
de Cruppé, W., Kleudgen, S., Diel, F., Burgdorf, F., & Geraedts, M. (2015). Feasibility of 48 quality indicators in ambulatory care in Germany: a cross-sectional observational study. Zeitschrift Fur Evidenz, Fortbildung Und Qualitat Im Gesundheitswesen, 109(9-10), 682-94. https://doi.org/10.1016/j.zefq.2015.02.015
de Cruppé W, et al. Feasibility of 48 Quality Indicators in Ambulatory Care in Germany: a Cross-sectional Observational Study. Z Evid Fortbild Qual Gesundhwes. 2015;109(9-10):682-94. PubMed PMID: 26699257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Feasibility of 48 quality indicators in ambulatory care in Germany: a cross-sectional observational study. AU - de Cruppé,Werner, AU - Kleudgen,Susanne, AU - Diel,Franziska, AU - Burgdorf,Friederike, AU - Geraedts,Max, Y1 - 2015/04/07/ PY - 2014/09/29/received PY - 2015/02/26/revised PY - 2015/02/27/accepted PY - 2015/12/25/entrez PY - 2015/12/25/pubmed PY - 2016/10/27/medline KW - Deutschland KW - Feasibility KW - Germany KW - Leistungsmessung KW - Machbarkeit KW - Qualitätsindikator KW - ambulante Gesundheitsversorgung KW - ambulatory care KW - performance measurement KW - quality indicator SP - 682 EP - 94 JF - Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen JO - Z Evid Fortbild Qual Gesundhwes VL - 109 IS - 9-10 N2 - BACKGROUND: The National Association of Statutory Health Insurance Physicians develops quality indicators (QIs) for ambulatory care in Germany. This study explores the feasibility of a total of 48 QIs. METHODS: Cross-sectional observational study with primary data collection in writing from medical practices in 10 specialist fields of outpatient care. "Feasibility" covers 7 criteria for indicator assessment and data collection: applicability, availability, retrievability, complexity, relevance, reliability, and acceptance. A questionnaire consisting of 10 questions was used to evaluate these feasibility criteria for each indicator. Survey results were subjected to descriptive analysis. RESULTS: The analyzed sample comprises 103 participants who have been working as practice-based physicians for an average of 13 years. 40% only keep electronic medical records and 2% only paper records, and the rest uses both. The rating of QIs in the field-specific QI sets shows the following mean values: 67% of the participants consider the QIs assigned to them as corresponding to their practice care mandate. Data on these QIs deemed to be applicable are collected by 94% of respondents, documented by 91%, and by 51% electronically. 58% of the data required for the denominator, and 38% for the numerator are retrievable from the practice management system. The time required to access data on a QI is more than 30minutes for 84% of respondents, and 67% consider the effort involved as unacceptable. The rating received was 61% for the relevance of QIs to the assessment of a practitioner's own quality of health care, 69% for the estimated reliability of data collection, and 58% for the acceptance of being evaluated via QIs. CONCLUSIONS: In order to improve the feasibility of QI-based practice assessments it will be necessary to a) fine-tune the selection of QIs for the respective groups of specialist, b) to promote the use of computerized practice management systems, and c) integrate effective and user-friendly retrieval functions in the software. Another aspect to be explored is how the acceptance of QI-based practice evaluations can be improved in individual specialist fields. SN - 2212-0289 UR - https://www.unboundmedicine.com/medline/citation/26699257/Feasibility_of_48_quality_indicators_in_ambulatory_care_in_Germany:_a_cross_sectional_observational_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1865-9217(15)00050-1 DB - PRIME DP - Unbound Medicine ER -