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[基层医疗中健康结局指标的识别。系统评价的综述]

[Identification of health outcome indicators in Primary Care. A review of systematic reviews].

作者信息

Olry de Labry Lima A, García Mochón L, Bermúdez Tamayo C

机构信息

Escuela Andaluza de Salud Pública (EASP), Granada, España; Instituto de Investigación Biosanitaria ibs.Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, España; CIBER en Epidemiología y Salud Pública (CIBERESP), España.

Escuela Andaluza de Salud Pública (EASP), Granada, España; Instituto de Investigación Biosanitaria ibs.Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, España.

出版信息

Rev Calid Asist. 2017 Sep-Oct;32(5):278-288. doi: 10.1016/j.cali.2017.08.001. Epub 2017 Oct 9.

Abstract

INTRODUCTION

Outcome measures are being widely used by health services to assess the quality of health care. It is important to have a battery of useful performance indicators with high validity and feasibility. Thus, the objective of this study is to perform a review of reviews in order to identify outcome indicators for use in Primary Care.

METHODOLOGY

A review of systematic reviews (umbrella review) was carried out. The following databases were consulted: MedLine, EMBASE, and CINAHL, using descriptors and free terms, limiting searches to documents published in English or Spanish. In addition, a search was made for free terms in different web pages. Those reviews that offered indicators that could be used in the Primary Care environment were included.

RESULTS

This review included a total of 5 reviews on performance indicators in Primary Care, which consisted of indicators in the following areas or clinical care processes: in osteoarthritis, chronicity, childhood asthma, clinical effectiveness, and prescription safety indicators. A total of 69 performance indicators were identified, with the percentage of performance indicators ranging from 0% to 92.8%. None of the reviews identified performed an analysis of the measurement control (feasibility or sensitivity to change of indicators).

CONCLUSIONS

This paper offers a set of 69 performance indicators that have been identified and subsequently validated and prioritised by a panel of experts.

摘要

引言

卫生服务机构广泛使用结果指标来评估医疗保健质量。拥有一系列具有高有效性和可行性的有用绩效指标非常重要。因此,本研究的目的是进行一项综述的综述,以确定用于初级保健的结果指标。

方法

进行了一项系统综述的综述(伞式综述)。查阅了以下数据库:MedLine、EMBASE和CINAHL,使用描述符和自由词,将搜索限制在以英语或西班牙语发表的文献。此外,还在不同网页上搜索了自由词。纳入那些提供可用于初级保健环境的指标的综述。

结果

本综述共纳入了5篇关于初级保健绩效指标的综述,这些综述包括以下领域或临床护理过程中的指标:骨关节炎、慢性病、儿童哮喘、临床有效性和处方安全指标。共确定了69个绩效指标,绩效指标的百分比范围为0%至92.8%。所纳入的综述均未对测量控制(指标的可行性或对变化的敏感性)进行分析。

结论

本文提供了一组69个绩效指标,这些指标已由专家小组进行了识别、随后验证并确定了优先级。

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