Department of Community Health Sciences and O'Brien Institute of Public Health, Calgary, Alberta, Canada.
Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada.
PLoS One. 2019 Jan 15;14(1):e0210794. doi: 10.1371/journal.pone.0210794. eCollection 2019.
To develop key performance indicators that evaluate the effectiveness of a prescription medication system.
A modified RAND/UCLA appropriateness method was used to develop key performance indicators (KPIs) for a prescription medication system. A broad list of potential KPIs was compiled. A multidisciplinary group composed of 21 experts rated the potential KPIs. A face-to-face meeting was held following the first rating exercise to discuss each potential KPI individually. The expert panel undertook a final rating of KPIs. The final set of KPIs were those indicators where at least 80 percent of experts rated the indicator highly i.e. rating of ≥ 7 on a scale from 1 to 9.
292 KPIs were identified from the published literature. After removing duplicates and combining similar indicators 71 KPIs were included. The final ranking resulted in six indicators being ranked 7 or higher by 80% of the respondents and an additional seven indicators being ranked 7 or higher by ≥70 but ≤80% of respondents. The six selected indicators include four specific disease areas, measure structural and process aspects of health service delivery, and assessed three of the domains of healthcare quality: efficiency, effectiveness, and safety.
These indicators are recommended as a starting point to assess the current performance of prescription medication systems. Consideration should be given to developing indicators in additional disease areas as well as indicators that measure the domains of timeliness and patient-centeredness. Future work should focus on the feasibility of measuring these indicators.
制定评估处方药物系统有效性的关键绩效指标。
采用改良版 RAND/UCLA 适宜性方法制定处方药物系统的关键绩效指标 (KPI)。编制了一份潜在 KPI 的广泛清单。由 21 名专家组成的多学科小组对潜在 KPI 进行了评分。在第一次评分后举行了一次面对面会议,逐个讨论每个潜在 KPI。专家小组对 KPI 进行了最终评分。最终的 KPI 是那些至少有 80%的专家对指标给予高度评价的指标,即评分在 1 到 9 的范围内为 7 或更高。
从已发表的文献中确定了 292 个 KPI。去除重复项并合并相似指标后,纳入了 71 个 KPI。最终排名结果显示,有 6 个指标得到了 80%的受访者的 7 分或更高评分,另有 7 个指标得到了≥70%但≤80%的受访者的 7 分或更高评分。这六个选定的指标包括四个特定的疾病领域,衡量卫生服务提供的结构和过程方面,并评估了医疗保健质量的三个领域:效率、效果和安全性。
这些指标被推荐作为评估处方药物系统当前绩效的起点。应考虑在其他疾病领域以及衡量及时性和以患者为中心的指标方面制定指标。未来的工作应侧重于衡量这些指标的可行性。