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自我报告的膝关节骨关节炎质量护理:丹麦、挪威、葡萄牙和英国的比较。

Self-reported quality care for knee osteoarthritis: comparisons across Denmark, Norway, Portugal and the UK.

机构信息

National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway.

Arthritis Research UK, Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University , Staffordshire , UK.

出版信息

RMD Open. 2015 Oct 20;1(1):e000136. doi: 10.1136/rmdopen-2015-000136. eCollection 2015.

Abstract

OBJECTIVES

To assess and compare patient perceived quality of osteoarthritis (OA) management in primary healthcare in Denmark, Norway, Portugal and the UK.

METHODS

Participants consulting with clinical signs and symptoms of knee OA were identified in 30 general practices and invited to complete a cross-sectional survey including quality indicators (QI) for OA care. A QI was considered as eligible if the participant had checked 'Yes' or 'No', and as achieved if the participant had checked 'Yes' to the indicator. The median percentage (with IQR and range) of eligible QIs achieved by country was determined and compared in negative binominal regression analysis. Achievement of individual QIs by country was determined and compared using logistic regression analyses.

RESULTS

A total of 354 participants self-reported QI achievement. The median percentage of eligible QIs achieved (checked 'Yes') was 48% (IQR 28%, 64%; range 0-100%) for the total sample with relatively similar medians across three of four countries. Achievement rates on individual QIs showed a large variation ranging from 11% (referral to services for losing weight) to 67% (information about the importance of exercise) with significant differences in achievement rates between the countries.

CONCLUSIONS

The results indicated a potential for improvement in OA care in all four countries, but for somewhat different aspects of OA care. By exploring these differences and comparing healthcare services, ideas may be generated on how the quality might be improved across nations. Larger studies are needed to confirm and further explore the findings.

摘要

目的

评估和比较丹麦、挪威、葡萄牙和英国初级医疗保健中患者对骨关节炎(OA)管理的感知质量。

方法

在 30 家普通诊所中确定了有膝关节 OA 临床症状和体征的参与者,并邀请他们完成一项横断面调查,其中包括 OA 护理质量指标(QI)。如果参与者勾选了“是”或“否”,则认为 QI 符合条件;如果参与者勾选了“是”,则认为 QI 已达到。确定并比较各国符合条件的 QI 达到的中位数百分比(带有 IQR 和范围),并在负二项回归分析中进行比较。使用逻辑回归分析确定并比较各国个别 QI 的实现情况。

结果

共有 354 名参与者自我报告了 QI 的实现情况。符合条件的 QI 实现(勾选“是”)的中位数百分比为 48%(IQR 28%,64%;范围 0-100%),总样本中位数相对相似,四个国家中有三个国家的中位数相似。个别 QI 的实现率差异很大,从 11%(转诊至服务机构减肥)到 67%(关于运动重要性的信息),各国之间的实现率存在显著差异。

结论

结果表明,所有四个国家的 OA 护理都有改进的潜力,但在 OA 护理的某些方面有所不同。通过探索这些差异并比较医疗保健服务,可以产生关于如何在各国提高质量的想法。需要进行更大规模的研究来证实和进一步探讨这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dbb/4623369/f6656c7ab697/rmdopen2015000136f01.jpg

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