Faculty of Education, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
The Jönköping Academy for Improvement of Health and Welfare, School of Health Sciences, Jönköping University, Jönköping, Sweden.
PLoS One. 2021 Jan 7;16(1):e0244874. doi: 10.1371/journal.pone.0244874. eCollection 2021.
Quality standards are important for improving health care by providing compelling evidence for best practice. High quality person-centered health care requires information on patients' experience of disease and of functioning in daily life.
To analyze and compare the content of five Swedish National Quality Registries (NQRs) and two standard sets of the International Consortium of Health Outcomes Measurement (ICHOM) related to cardiovascular diseases.
An analysis of 2588 variables (= data items) of five NQRs-the Swedish Registry of Congenital Heart Disease, Swedish Cardiac Arrest Registry, Swedish Catheter Ablation Registry, Swedish Heart Failure Registry, SWEDEHEART (including four sub-registries) and two ICHOM standard sets-the Heart Failure Standard Set and the Coronary Artery Disease Standard Set. According to the name and definition of each variable, the variables were mapped to Donabedian's quality criteria, whereby identifying whether they capture health care processes or structures or patients' health outcomes. Health outcomes were further analyzed whether they were clinician- or patient-reported and whether they capture patients' physiological functions, anatomical structures or activities and participation.
In total, 606 variables addressed process quality criteria (31%), 58 structure quality criteria (3%) and 760 outcome quality criteria (38%). Of the outcomes reported, 85% were reported by clinicians and 15% by patients. Outcome variables addressed mainly 'Body functions' (n = 392, 55%) or diseases (n = 209, 29%). Two percent of all documented data captured patients' lived experience of disease and their daily activities and participation (n = 51, 3% of all variables).
Quality standards in the cardiovascular field focus predominately on processes (e.g. treatment) and on body functions-related outcomes. Less attention is given to patients' lived experience of disease and their daily activities and participation. The results can serve as a starting-point for harmonizing data and developing a common person-centered quality indicator set.
质量标准通过为最佳实践提供有力证据，对改善医疗保健至关重要。高质量的以患者为中心的医疗保健需要了解患者对疾病和日常生活功能的体验。
分析和比较与心血管疾病相关的五个瑞典国家质量登记处（NQR）和两个国际卫生结果测量联合会（ICHOM）标准集的内容。
对五个 NQR（瑞典先天性心脏病登记处、瑞典心脏骤停登记处、瑞典导管消融登记处、瑞典心力衰竭登记处、SWEDEHEART（包括四个子登记处）和两个 ICHOM 标准集——心力衰竭标准集和冠状动脉疾病标准集）的 2588 个变量（=数据项）进行分析。根据每个变量的名称和定义，将变量映射到 Donabedian 的质量标准，从而确定它们是否捕捉医疗保健过程、结构或患者的健康结果。进一步分析健康结果是否由临床医生或患者报告，以及它们是否捕捉患者的生理功能、解剖结构或活动和参与。
总共 606 个变量涉及过程质量标准（31%）、58 个结构质量标准（3%）和 760 个结果质量标准（38%）。报告的结果中，85%由临床医生报告，15%由患者报告。结果变量主要涉及“身体功能”（n = 392，55%）或疾病（n = 209，29%）。所有记录数据的 2%捕捉了患者对疾病的生活体验及其日常活动和参与（n = 51，占所有变量的 3%）。
心血管领域的质量标准主要侧重于过程（例如治疗）和与身体功能相关的结果。对患者对疾病的生活体验及其日常活动和参与的关注较少。结果可以作为协调数据和制定共同以患者为中心的质量指标集的起点。
