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Assessing appropriateness of osteoarthritis care using quality indicators: a systematic review
Author(s) -
Basedow Martin,
Esterman Adrian
Publication year - 2015
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12402
Subject(s) - medicine , cinahl , medline , psycinfo , health care , referral , physical therapy , family medicine , emergency medicine , psychological intervention , nursing , political science , law , economics , economic growth
Rationale, aims and objectives Quality indicators ( QI s) derived from the review of medical records, administrative databases, and patient questionnaires and interviews have been frequently used to assess the quality of osteoarthritis ( OA ) care. The purpose of this review is to summarize studies that have assessed the quality of OA care using QI s. Method We systematically searched MEDLINE , EMBASE , CINAHL and PsycINFO for English‐language studies indexed by O ctober 2014. Articles were included if they used any QI s for assessing the quality of OA care. We summarized the results of these studies, and with meta‐analysis, generated an overall conclusion about the quality of care as measured by QI s for each treatment domain for OA care. Results Fourteen studies assessed as being of high‐quality were included in the review, with the number of QI s ranging from 1 to 21. Four of the 14 studies solely assessed the quality of OA care, while the other studies assessed health care quality for a range of conditions that included OA . The quality of OA care as assessed by a meta‐analysis of QI pass rates across studies was suboptimal for all treatment domains (pass rates: pain and functional status assessment – 48.5%, 95% CI 32.6–64.6%; non‐drug treatment – 36.1%, 95% CI 27.8–44.7%; drug treatment – 37.5%, 95% CI 30.8–44.5%; surgical referral – 78.9%, 95% CI 57.4–94.2%). Conclusion Despite efforts made at improving care for patients with OA , the wide divergence between evidence and consensus‐based recommended care and practice has been reaffirmed.