Self-reported quality care for knee osteoarthritis: comparisons across Denmark, Norway, Portugal and the UK.
Self-reported quality care for knee osteoarthritis: comparisons across Denmark, Norway, Portugal and the UK.
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DOI：
10.1136/rmdopen-2015-000136
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发表时间：
2015
期刊：
影响因子：
6.2
通讯作者：
Hagen KB
中科院分区：
文献类型：
--
作者：
Østerås N;Jordan KP;Clausen B;Cordeiro C;Dziedzic K;Edwards J;Grønhaug G;Higginbottom A;Lund H;Pacheco G;Pais S;Hagen KB
评估和比较丹麦、挪威、葡萄牙和英国患者对初级医疗保健中骨关节炎 (OA) 管理质量的感知。在 30 个常规实践中确定了咨询膝关节 OA 临床体征和症状的参与者，并邀请他们完成一项横断面调查，其中包括 OA 护理的质量指标 (QI)。如果参与者勾选“是”或“否”，则 QI 被视为合格；如果参与者对该指标勾选“是”，则视为已达到 QI。确定国家达到的合格 QI 的中位数百分比（包括 IQR 和范围），并在负二项回归分析中进行比较。使用逻辑回归分析来确定和比较各个国家的个别质量指标的实现情况。共有 354 名参与者自我报告了 QI 成绩。总样本中，达到合格 QI 的百分比（勾选“是”）为 48%（IQR 28%、64%；范围 0-100%），四个国家中的三个国家的中位数相对相似。各个 QI 的达成率差异很大，从 11%（推荐减肥服务）到 67%（有关锻炼重要性的信息）不等，各国之间的达成率存在显着差异。结果表明，所有四个国家的骨关节炎护理都有改善的潜力，但骨关节炎护理的方面有所不同。通过探索这些差异并比较医疗保健服务，可以就如何提高各国的质量产生想法。需要更大规模的研究来证实并进一步探索这些发现。
To assess and compare patient perceived quality of osteoarthritis (OA) management in primary healthcare in Denmark, Norway, Portugal and the UK. Participants consulting with clinical signs and symptoms of knee OA were identified in 30 general practices and invited to complete a cross-sectional survey including quality indicators (QI) for OA care. A QI was considered as eligible if the participant had checked ‘Yes’ or ‘No’, and as achieved if the participant had checked ‘Yes’ to the indicator. The median percentage (with IQR and range) of eligible QIs achieved by country was determined and compared in negative binominal regression analysis. Achievement of individual QIs by country was determined and compared using logistic regression analyses. A total of 354 participants self-reported QI achievement. The median percentage of eligible QIs achieved (checked ‘Yes’) was 48% (IQR 28%, 64%; range 0–100%) for the total sample with relatively similar medians across three of four countries. Achievement rates on individual QIs showed a large variation ranging from 11% (referral to services for losing weight) to 67% (information about the importance of exercise) with significant differences in achievement rates between the countries. The results indicated a potential for improvement in OA care in all four countries, but for somewhat different aspects of OA care. By exploring these differences and comparing healthcare services, ideas may be generated on how the quality might be improved across nations. Larger studies are needed to confirm and further explore the findings.