银屑病护理质量及指南依从性治疗的评估。一种新的质量指标体系的建立。

Evaluation of quality of care and guideline-compliant treatment in psoriasis. Development of a new system of quality indicators.

作者信息

Radtke M A, Reich K, Blome C, Kopp I, Rustenbach S J, Schäfer I, Augustin M

机构信息

German Center for Health Services Research in Dermatology (CVderm), Department of Dermatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Dermatology. 2009;219(1):54-8. doi: 10.1159/000218161. Epub 2009 May 7.

DOI:10.1159/000218161

PMID:19420901

Abstract

BACKGROUND

To date, no standardised indicators for quality of care in psoriasis have been published.

AIMS

Development and testing of evidence-based indicators of quality of care and guideline compliance in the treatment of psoriasis.

METHODS

Indicators of process and outcome quality were extracted and evaluated in a Delphi process according to international standards. The primary reference was the S3 German guideline for psoriasis treatment. The indicators were validated with data from two nationwide studies on psoriasis care involving 1,511 and 2,009 patients.

RESULTS

Eight quality indicators were defined: mean PASI, mean quality of life (Dermatology Life Quality Index; DLQI), proportion of patients with PASI >20, with DLQI >10, with previous systemic treatment, with PASI >20 and systemic treatment, with inpatient treatment, and number of work days lost. All indicators proved suitable for application, and were sensitive to change.

CONCLUSIONS

Guideline-based indicators of quality of care are useful in the analysis of health care and the implementation of treatment guidelines in psoriasis.

摘要

背景

迄今为止，尚未发布银屑病护理质量的标准化指标。

目的

制定并测试银屑病治疗中基于证据的护理质量指标和指南依从性指标。

方法

根据国际标准，在德尔菲法过程中提取并评估过程和结果质量指标。主要参考文献为德国银屑病治疗S3指南。这些指标通过两项全国性银屑病护理研究的数据进行验证，涉及1511名和2009名患者。

结果

定义了八项质量指标：平均银屑病面积和严重程度指数（PASI）、平均生活质量（皮肤病生活质量指数；DLQI）、PASI>20的患者比例、DLQI>10的患者比例、接受过全身治疗的患者比例、PASI>20且接受过全身治疗的患者比例、接受住院治疗的患者比例以及损失的工作日数。所有指标均证明适用于应用，且对变化敏感。