Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Quality Association for Acute Stroke Treatment Schleswig-Holstein (QugSS)].
The Quality Association for Acute Stroke Treatment Schleswig-Holstein (QugSS) continues a project which was conducted from 2004 to 2007 as part of a benchmarking programme funded by the German Health Ministry. The implementation of the benchmarking programme in 15 hospitals was intended to improve patient-related outcomes of the inpatient treatment of acute stroke. Regular reports to the Quality Association are complemented by quarterly meetings of the association members to compare and discuss the results of the participating hospitals. ⋯ Between April 2005 and December 2010 approx. 18,000 cases (mean age: 71.9±12.8 years/M±SD, 48.7% females) were documented. From 2008 to 2010, nine out of 12 process indicators improved significantly. Values above the pre-defined target level of the quality indicators were significantly achieved by five indicators (p<.05), almost achieved by three indicators (not significant), and were significantly failed by four indicators.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Randomized Controlled Trial Multicenter Study[Does implementation of benchmarking in quality circles improve the quality of care of patients with asthma and reduce drug interaction?].
The purpose of this cluster-randomised controlled trial was to evaluate the efficacy of quality circles (QCs) working either with general data-based feedback or with an open benchmark within the field of asthma care and drug-drug interactions. ⋯ General practitioners seem to take a critical perspective about open benchmarking in quality circles. Caution should be used when implementing benchmarking in a quality circle as it did not improve healthcare when compared to the traditional procedure with anonymised comparisons.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Review[Using routine data for quality of care assessments: a critical review, taking quality indicators for the "National Disease Management Guideline for Chronic Heart Failure" as an example].
In December 2009, the first version of the German Disease Management Guideline (DM-CPG) for chronic heart failure was completed, including a set of proposed quality indicators for heart failure. This article explores whether proposed indicators can be derived from data collected routinely in general practices. For this purpose, previous experiences and data from the research project CONTENT (CONTinuous morbidity registration Epidemiologic NeTwork) conducted under guidance of the Department of General Medicine and Health Services Research at the University of Heidelberg, Germany, were applied. ⋯ This was the indicator measuring the proportion of patients receiving beta receptor antagonists, compared to all patients with heart failure NYHA class II to IV. Indeed, this single indicator will only be computable if the NYHA grade of heart failure severity and the presence or absence of contraindications to beta receptor antagonist therapy are routinely collected and the data merged into a central database. Against the background of these results it is obvious that a fully developed, transsectoral concept for data collection and data transfer needs to be implemented.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Comparative StudyPreparing primary care for the future - perspectives from the Netherlands, England, and USA.
All modern healthcare systems need to respond to the common challenges posed by an aging population combined with a growing number of patients with (complex) chronic conditions and rising patient expectations. Countries with 'stronger' primary care systems (e.g. the Netherlands and England) seem to be better prepared to address these challenges than countries with 'weaker' primary care (e.g. USA). The role of primary care in a health care system is strongly related to its organisation and funding, thus determining the starting point and the possibilities for change. ⋯ Organisation and financing of health care differ widely in the three countries. However, the necessity to improve coordination and integration of chronic disease care remains a common and core challenge.