Development of paediatric quality of inpatient care indicators for low-income countries - A Delphi study
Development of paediatric quality of inpatient care indicators for low-income countries - A Delphi study
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DOI：
10.1186/1471-2431-10-90
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发表时间：
2010-12-14
期刊：
影响因子：
2.4
通讯作者：
English, Mike
中科院分区：
文献类型：
--
作者：
Ntoburi, Stephen;Hutchings, Andrew;English, Mike
背景：低收入国家医院儿童护理质量指标已被提出，但缺乏关于其感知有效性和可接受性的信息。方法：从现有的、主要是定性的世卫组织评估工具和指南中选择代表六种常见疾病护理的结构和过程方面的潜在指标。我们使用德尔菲法，结合专家意见和现有的科学信息，评估他们的感知有效性和可接受性。结果：根据预先指定的共识标准，提交给专家的大多数指标被接受：国际专家组和地方专家组的指标分别为112/137(82%)和94/133(71%)。对于其他指标，没有达成共识；没有一项指标被否决。大多数指标在与结果的联系、可靠性、相关性、可操作性和优先次序方面得到高度评价，但在常规条件下收集数据的可行性方面得分较低。结论：这项德尔菲研究提供了证据，证明了低收入国家建议使用的一套儿童医院护理质量衡量标准中的大多数被认为是有用的。然而，国际和当地专家都表示关切的是，目前可能没有许多基于进程的指标的数据。应审查广泛质量评估的可行性和指标对干预的响应性，作为改进医院质量评估信息化方法的持续努力的一部分。
Background: Indicators of quality of care for children in hospitals in low-income countries have been proposed, but information on their perceived validity and acceptability is lacking.Methods: Potential indicators representing structural and process aspects of care for six common conditions were selected from existing, largely qualitative WHO assessment tools and guidelines. We employed the Delphi technique, which combines expert opinion and existing scientific information, to assess their perceived validity and acceptability. Panels of experts, one representing an international panel and one a national (Kenyan) panel, were asked to rate the indicators over 3 rounds and 2 rounds respectively according to a variety of attributes.Results: Based on a pre-specified consensus criteria most of the indicators presented to the experts were accepted: 112/137(82%) and 94/133(71%) for the international and local panels respectively. For the other indicators there was no consensus; none were rejected. Most indicators were rated highly on link to outcomes, reliability, relevance, actionability and priority but rated more poorly on feasibility of data collection under routine conditions. There was moderate to substantial agreement between the two panels of experts.Conclusions: This Delphi study provided evidence for the perceived usefulness of most of a set of measures of quality of hospital care for children proposed for use in low-income countries. However, both international and local experts expressed concerns that data for many process-based indicators may not currently be available. The feasibility of widespread quality assessment and responsiveness of indicators to intervention should be examined as part of continued efforts to improve approaches to informative hospital quality assessment.