• Shingo Fukuma, Sayaka Shimizu, Kakuya Niihata, Ken-Ei Sada, Motoko Yanagita, Tsuguru Hatta, Masaomi Nangaku, Ritsuko Katafuchi, Yoshiro Fujita, Junji Koizumi, Shunzo Koizumi, Kenjiro Kimura, Shunichi Fukuhara, and Yugo Shibagaki.
• Department of Healthcare Epidemiology, Kyoto University, Yoshida-konoe, Sakyo-ku, Kyoto, Japan.
• Clin. Exp. Nephrol. 2017 Apr 1; 21 (2): 247-256.

BackgroundThe prevalence of chronic kidney disease (CKD) has recently increased, and maintaining high quality of CKD care is a major factor in preventing end-stage renal disease. Here, we developed novel quality indicators for CKD care based on existing electronic health data.MethodsWe used a modified RAND appropriateness method to develop quality indicators for the care of non-dialysis CKD patients, by combining expert opinion and scientific evidence. A multidisciplinary expert panel comprising six nephrologists, two primary care physicians, one diabetes specialist, and one rheumatologist assessed the appropriateness of potential indicators extracted from evidence-based clinical guidelines, in accordance with predetermined criteria. We developed novel quality indicators through a four-step process: selection of potential indicators, first questionnaire round, face-to-face meeting, and second questionnaire round.ResultsTen expert panel members evaluated 19 potential indicators in the first questionnaire round, of which 7 were modified, 12 deleted, and 4 newly added during subsequent face-to-face meetings, giving a final total of 11 indicators. Median rate of these 11 indicators in the final set was at least 7, and percentages of agreement exceeded 80 % for all but one indicator. All indicators in the final set can be measured using only existing electronic health data, without medical record review, and 9 of 11 are process indicators.ConclusionWe developed 11 quality indicators to assess quality of care for non-dialysis CKD patients. Strengths of the developed indicators are their applicability in a primary care setting, availability in daily practice, and emphasis on modifiable processes.

29 keywords...

hide…