Semlitsch Thomas, Abuzahra Muna, Stigler Florian, Jeitler Klaus, Posch Nicole, Siebenhofer Andrea
Institut für Allgemeinmedizin und evidenzbasierte Versorgungsforschung, Medizinische Universität Graz, Graz, Österreich.
Gesundheitswesen. 2019 Jul;81(7):527-538. doi: 10.1055/s-0043-112745. Epub 2017 Jul 11.
The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities.
The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept.
We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility.
Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1).
This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population.
加强初级卫生保健是奥地利当前国家卫生改革的一个主要目标。在此背景下，2014年制定了一项新的跨学科概念，该概念界定了未来初级卫生保健机构的结构和要求。
本项目的目的是制定质量指标，以评估奥地利符合新奥地利概念的预定初级卫生保健机构。
我们使用兰德/国家预防保健研究与发展中心方法来制定和选择质量指标。我们在国际质量指标数据库以及书目数据库中对现有措施进行了系统的文献检索。所有检索到的措施均由一个专家小组分两步就相关性和可行性进行评估和评级。
总体而言，文献检索产生了281个潜在相关的质量指标，这些指标被归纳为65个不同的初级卫生保健质量措施。其中，专家小组将30项措施评为与奥地利相关且可行。这些指标中有5项是结构指标，14项是过程指标，其余11项是结果指标。根据奥地利初级卫生保健概念，最终的质量指标集分为以下5个领域：获得初级卫生保健（5项）、护理质量（15项）、护理连续性（5项）、护理协调（4项）和安全（1项）。
这套质量措施在很大程度上涵盖了初级卫生保健的四个既定功能。它能够对奥地利初级卫生保健机构在实施奥地利初级卫生保健概念方面以及在改善民众医疗保健方面进行标准化评估。
