Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, Ontario, M5T 3M6, Canada.
Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, 10th Floor, Toronto, Ontario, M5G 2C4, Canada.
Syst Rev. 2017 Jul 3;6(1):126. doi: 10.1186/s13643-017-0530-7.
Despite the growing interest in assessing the quality of care for depression, there is little evidence to support measurement of the quality of primary care for depression. This study identified evidence-based quality indicators for monitoring, evaluating and improving the quality of care for depression in primary care settings.
Ovid MEDLINE and Ovid PsycINFO databases, and grey literature, including relevant organizational websites, were searched from 2000 to 2015. Two reviewers independently selected studies if (1) the study methodology combined a systematic literature search with assessment of quality indicators by an expert panel and (2) quality indicators were applicable to assessment of care for adults with depression in primary care settings. Included studies were appraised using the Appraisal of Indicators through Research and Evaluation (AIRE) instrument, which contains four domains and 20 items. A narrative synthesis was used to combine the indicators within themes. Quality indicators applicable to care for adults with depression in primary care settings were extracted using a structured form. The extracted quality indicators were categorized according to Donabedian's 'structure-process-outcome' framework.
The search revealed 3838 studies. Four additional publications were identified through grey literature searching. Thirty-nine articles were reviewed in detail and seven met the inclusion criteria. According to the AIRE domains, all studies were clear on purpose and stakeholder involvement, while formal endorsement and usage of indicators in practice were scarcely described. A total of 53 quality indicators were identified from the included studies, many of which overlap conceptually or in content: 15 structure, 33 process and four outcome indicators. This study identified quality indicators for evaluating primary care for depression among adult patients.
The identified set of indicators address multiple dimensions of depression care and provide an excellent starting point for further development and use in primary care settings.
尽管人们对评估抑郁症护理质量的兴趣日益浓厚，但几乎没有证据支持对初级保健中抑郁症护理质量的衡量。本研究确定了用于监测、评估和改善初级保健中抑郁症护理质量的基于证据的质量指标。
对 Ovid MEDLINE 和 Ovid PsycINFO 数据库以及灰色文献（包括相关组织网站）进行了 2000 年至 2015 年的检索。如果（1）研究方法将系统文献检索与专家小组评估质量指标相结合，以及（2）质量指标适用于评估初级保健中成年人抑郁症的护理，两位评审员将独立选择研究。使用 Appraisal of Indicators through Research and Evaluation（AIRE）工具评估纳入研究，该工具包含四个领域和 20 个项目。使用叙述性综合法在主题内组合指标。使用结构化表格提取适用于初级保健中成年人抑郁症护理的质量指标。根据 Donabedian 的“结构-过程-结果”框架对提取的质量指标进行分类。
检索显示有 3838 项研究。通过灰色文献检索又确定了 4 项出版物。详细审查了 39 篇文章，其中 7 篇符合纳入标准。根据 AIRE 领域，所有研究均明确了目的和利益相关者的参与，而很少有研究描述指标的正式认可和实际使用情况。从纳入的研究中确定了 53 项质量指标，其中许多指标在概念上或内容上重叠：15 项结构指标、33 项过程指标和 4 项结果指标。本研究确定了用于评估成年患者初级保健中抑郁症的质量指标。
确定的这组指标涵盖了抑郁症护理的多个维度，为进一步在初级保健环境中开发和使用提供了极好的起点。
Zotero 插件