Parzanka Susanne, Himstedt Christian, Deck Ruth
Institut für Sozialmedizin und Epidemiologie der Universität Lübeck, Deutschland.
Institut für Sozialmedizin und Epidemiologie der Universität Lübeck, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2015;109(8):578-84. doi: 10.1016/j.zefq.2015.09.028. Epub 2015 Nov 14.
Existing rehabilitation aftercare offers in Germany are heterogeneous, and there is a lack of transparency in terms of indications and methods as well as of (nationwide) availability and financial coverage. Also, there is no systematic and transparent synopsis. To close this gap a systematic review was conducted and a web-based database created for post-rehabilitation support. To allow a consistent assessment of the included aftercare offers, a quality profile of universally valid criteria was developed. This paper aims to outline the scientific approach.
The procedure adapts the RAND/UCLA method, with the participation of the advisory board of the ReNa project. Preparations for the set included systematic searches in order to find possible criteria to assess the quality of aftercare offers. These criteria first were collected without any pre-selection involved. Every item of the adjusted collection was evaluated by every single member of the advisory board considering the topics "relevance", "feasibility" and "suitability for public coverage". Interpersonal analysis was conducted by relating the median and classification into consensus and dissent. All items that were considered to be "relevant" and "feasible" in the three stages of consensus building and deemed "suitable for public coverage" were transferred into the final set of criteria (ReNa set).
A total of 82 publications were selected out of the 656 findings taken into account, which delivered 3,603 criteria of possible initial relevance. After a further removal of 2,598 redundant criteria, the panel needed to assess a set of 1,005 items. Finally we performed a quality assessment of aftercare offers using a set of 35 descriptive criteria merged into 8 conceptual clusters.
The consented ReNa set of 35 items delivers a first generally valid tool to describe quality of structures, standards and processes of aftercare offers. So finally, the project developed into a complete collection of profiles characterizing each post-rehabilitation support service included in the database.
德国现有的康复后续护理服务参差不齐,在适应症、方法以及(全国范围内的)可及性和财务覆盖方面缺乏透明度。此外,也没有系统且透明的概述。为填补这一空白,我们进行了一项系统综述,并创建了一个基于网络的康复后支持数据库。为了对纳入的后续护理服务进行一致评估,我们制定了一套普遍适用标准的质量概况。本文旨在概述科学方法。
该程序采用了兰德/加州大学洛杉矶分校的方法,并由ReNa项目咨询委员会参与。该集合的准备工作包括系统搜索,以找到评估后续护理服务质量的可能标准。这些标准首先在没有任何预先筛选的情况下收集。咨询委员会的每一位成员都根据“相关性”“可行性”和“适合公共覆盖”的主题对调整后的集合中的每一项进行了评估。通过关联中位数并分类为共识和异议进行人际分析。在共识建立的三个阶段中被认为“相关”和“可行”且被视为 “适合公共覆盖” 的所有项目都被纳入最终的标准集(ReNa集)。
在考虑的656项研究结果中,共选出82篇出版物,这些出版物提供了3603条可能具有初步相关性的标准。在进一步剔除2598条冗余标准后,专家组需要评估一组1005项内容。最后,我们使用一组35条描述性标准(合并为8个概念集群)对后续护理服务进行了质量评估。
经同意的包含35项内容的ReNa集提供了第一个普遍有效的工具,用于描述后续护理服务的结构、标准和流程的质量。因此,该项目最终发展成为一个完整的概况集,对数据库中包含的每项康复后支持服务进行了特征描述。