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Clinical records: main results of the anaysis

Clinical records: main results of the anaysis. UTartu 25.10.2012 Tallinn. Development of the list of the clinical indicators.

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Clinical records: main results of the anaysis

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  1. Clinical records: main results of the anaysis UTartu 25.10.2012 Tallinn

  2. Development of the list of the clinical indicators • No goodevidence available what set of the clinical indicators derived directly from clinical records is best for quality comparisons across countries or different primary care-systems • A set of clinical quality indicators for medical audit was developed within EUPrimecareproject • Starting point for the selection has been set of the health care quality indicators developed by OECD (concerningtochroniccommonconditions)

  3. Clinical quality indicators for medical audit

  4. 1. OECD, 2 American Diabetes Association; European Association for Study of Diabetes.3 . European guidelines on cardiovascular disease prevention in clinical practice: executive summary:5. 5Whitworth JA; World Health Organization, International Society of Hypertension Writing Group.2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension.

  5. Datacollection • Estonia – national data, collection in individual patient level, all indicators (260 health care providers, 2 diabetes cases and 2 hypertensive cases from each) • Lithuania- aggregated data, health centres of Kaunas region, all indicators • Hungary- aggregated, national level (by age groups and sex), not all proposed indicators (Healthcare Episode Database ) • Spain – aggregated data, almost all indicators (32 health centres) • Germany- aggregated data from Disease Management Program, not all proposed indicators (not completed yet) • Finland – aggregated data, all indicators? due data protection regulations Finland is not to allow send individualized data, only tabulated results(not completed yet). • Italy- aggregated data, only some of the indicators from Emilia Romagna Region Data 2010 (3500 GPs)

  6. Study subjects and period Dataof: • all patientswithdiagnosisofdiabetestype II (diagnoses E11 and E11.0 – E11.9 accordingtothe ICD-10 classification) • all patientswithdiagnosisofhypertension (diagnoses I10, I11, I12, I13 accordingtothe ICD-10 classification) • Year 2011

  7. Results

  8. Conclusions • Results of clinical indicator in different countries varied quite a lot • Data collection methodology is different (can we compare?) • We can not conclude any specific relation between clinical performance and PHC models since 2 countries did not finished the study yet

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