QUALITY-OF-CARE INDICATORS FOR OVERACTIVE BLADDER SYMPTOMS

膀胱过度活动症（OAB）由国际尿失禁协会定义为尿急，伴有或 无急迫性尿失禁，常伴尿频和尿失禁。我们非常需要质量- 对有OAB症状的女性进行护理研究。本研究的总体目标是开发和试点测试一套 OAB妇女的护理质量指标，强调结构，过程和结果的措施。 詹妮弗愤怒，医学博士，公共卫生硕士，最近完成了NRSA卫生服务研究奖学金。她 研究了供应商变量对压力性尿失禁妇女手术结果的影响， 失禁她提出的职业发展项目和相关课程将大大扩展她的 膀胱过度活动症和急迫性尿失禁领域的研究经验。这个目标 奖励期是为了让愤怒博士作为泌尿健康研究者实现完全独立 服务研究。她将接受广泛的新培训，每个拟议的具体目标：1） 系统地回顾和总结了关于OAB治疗的文献，包括结构/过程， 和成果衡量标准。培训：系统性文献综述2）与患者进行焦点小组讨论， 了解接受OAB症状治疗的女性最需要的信息。一部分 在这些焦点小组中，我们还将确定哪些结果对膀胱过度活动症患者最重要 症状培训：定性研究方法3）与医生专家进行访谈， 失禁我们将确定他们认为对以下方面至关重要的结构、过程和结果措施： 为患有OAB的女性提供优质护理。培训：专家访谈和数据分析4） 召集一个专家共识小组，制定候选指标清单并对其进行评级。训练：The 兰德公司/加州大学洛杉矶分校适当的方法5）试点测试我们最终提出的质量指标，以评估 它们的可行性和敏感性，同时寻求确定初级保健之间的护理差异 两个医疗系统的诊所。培训：图表提取、方法学、数据分析 相关性：鉴于膀胱过度活动症的高患病率和低治愈率， 通过制定护理质量指标为OAB妇女提供护理， 患者治疗，并最终改善患者的预后。

Overactive bladder (OAB) is defined by the International Continence Society as urinary urgency, with or without urge urinary incontinence, usually with frequency and nocturia. There is a great need for quality-of- care research for women with OAB symptoms. The overall goal of this study is to develop and pilot test a set of indicators of quality of care for women with OAB, emphasizing structure, process, and outcome measures. Dr. Jennifer Anger, MD, MPH, recently completed a NRSA health services research fellowship. She studied the effect of provider variables on outcomes of incontinence surgery for women with stress urinary incontinence. Her proposed career development project and related coursework will greatly expand her research experience into the area of overactive bladder and urge urinary incontinence. The goal of this award period is for Dr. Anger to achieve complete independence as an investigator in urological health services research. She will receive extensive new training with each proposed Specific Aim: 1) To systematically review and summarize the literature on treatment of OAB, incorporating structure/process, and outcomes measures. Training: Systematic literature review 2) To conduct focus groups with patients to understand what information is most needed by women who undergo treatment for OAB symptoms. As part of these focus groups, we will also determine what outcomes matter most to patients with overactive bladder symptoms. Training: Qualitative research methods 3) To conduct interviews with physician experts in incontinence. We will determine what structure, process, and outcomes measures they consider essential to providing excellent quality care for women with OAB. Training: Expert interviews and data analysis 4) To convene an expert consensus panel to develop and rate the list of candidate indicators. Training: The RAND/UCLA Appropriateness Method 5) To pilot test our final set of proposed quality indicators to evaluate their feasibility and sensitivity while simultaneously seeking to identify variation in care between primary care clinics in two healthcare systems. Training: Chart abstraction, methodology, data analysis Relevance: Given the high prevalence and poor cure rate for overactive bladder, improving the quality of care provided to women with OAB through the development of quality-of-care indicators will lead to better patient treatment, and, ultimately, improved patient outcomes.