Paediatric Primary Care Centre, Regensburg, Germany.
European Association of Primary Care Paediatricians, ECPCP, Rheinfelden, Germany.
Eur J Pediatr. 2019 May;178(5):707-719. doi: 10.1007/s00431-019-03344-5. Epub 2019 Feb 23.
There is a need to measure and improve the quality of paediatric primary care in Europe where major differences in the delivery and outcomes of child health care exist. A collaborative panel of paediatric senior experts developed a Core Set of Indicators for Paediatric Primary Care in Europe by compiling 42 quality indicators in a modified consensus process following the RAND/UCLA appropriateness method. The aim of this study was to explore the feasibility of the quality indicator set in European paediatric primary care practices. Seventy-nine practices from eight countries participated in a detailed online interview. The practices rated the applicability, relevance, reliability and acceptance of the 42 quality indicator as well as the availability, technical feasibility and effort to retrieve the needed data from their medical records. Most quality indicators were considered applicable, available, reliable, acceptable and relevant for monitoring quality of care in paediatric primary care. Respondents rated feasibility and effort to retrieve the data lowest because of difficulties collecting the data from the medical records.Conclusion: European paediatric primary care practices generally agree with the proposed quality indicator set. They document most of the parameters. However, the collection of specific needed values from available routine patient-data is considered technically difficult and time-consuming. What is Known? • Paediatric primary care systems in Europe show striking differences in their performance. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care. • A Core Set of 42 quality indicators for paediatric primary care in Europe was developed by European paediatricians using a systematic literature review and a consensus process following a modified RAND/UCLA appropriateness method. What is New? • Paediatric primary care providers in Europe agree with the idea to use COSI-PPC-EU to monitor and improve the quality of care. The set was considered applicable, available, reliable, acceptable, and relevant for quality improvement. • The score for feasibility and effort to retrieve the data was low, because of technical reasons; the electronical or paper-based medical documentation in most cases does not allow convenient access to all necessary data.
在欧洲，儿科初级保健的质量需要得到衡量和提高，因为儿童保健的提供和结果存在着巨大的差异。一个由儿科资深专家组成的合作小组通过采用改良的 RAND/UCLA 适宜性方法，在共识过程中编制了 42 个质量指标，从而制定了《欧洲儿科初级保健核心指标集》。本研究旨在探讨该质量指标集在欧洲儿科初级保健实践中的可行性。来自 8 个国家的 79 个实践单位参与了详细的在线访谈。这些实践单位对 42 个质量指标的适用性、相关性、可靠性和可接受性，以及从病历中获取所需数据的可用性、技术可行性和努力程度进行了评估。大多数质量指标被认为适用于监测儿科初级保健的护理质量，且是可用的、可靠的、可接受的和相关的。受访者对数据检索的可行性和难度评价最低，因为从病历中收集数据存在困难。结论：欧洲儿科初级保健实践单位普遍同意所提出的质量指标集。他们记录了大部分参数。然而，从可用的常规患者数据中收集特定的所需值被认为在技术上具有难度并且耗时。已知的是？ • 欧洲的儿科初级保健系统在绩效方面存在显著差异。现有的质量指标集主要局限于国家人口、特定疾病和医院护理。 • 欧洲儿科医生使用系统文献回顾和改良的 RAND/UCLA 适宜性方法共识过程制定了欧洲儿科初级保健的 42 项核心指标集。新的是？ • 欧洲的儿科初级保健提供者同意使用 COSI-PPC-EU 来监测和提高护理质量的想法。该指标集被认为适用于提高质量，是可用的、可靠的、可接受的和相关的。 • 数据检索的可行性和难度评分较低，这是由于技术原因；大多数情况下，电子或纸质病历无法方便地获取所有必要的数据。
