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The Critical Appraisal of Quality of Care Indicators

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Author(s): Michel P | Amouretti M | Juge C | Mathloulin-Pelissier S | Mazou H | Phely-Peyronnaud C | Rossignol C | Salmi L-R

Journal: Revue médicale de l'assurance maladie
ISSN 0767-2004

Volume: 32;
Issue: 2;
Start page: 201;
Date: 2001;
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Keywords: quality indicators | quality of care | critical appraisal

ABSTRACT
Aim: To elaborate criteria for the critical appraisal of quality of care indicators. Methods: We based our critical appraisal on the essential elements for describing and assessing quality of care indicators found in the published literature. The resulting grid was tested by methodology specialists and health-care professionals with respect to its implicit and explicit convenience. Results: The grid contains seven sections. The first three sections analyse the characteristics needed to describe the indicators. The title should explain the indicator’s overall content and describe its type. The numerator contains the parameters measured while the denominator quantifies the population studied. In addition, inclusion and exclusion criteria, data lists and sources, the codification used and the modalities of quality of care control need to be clearly defined. The last four sections concern the performance of the indicators and include whether the measurements are reproducible and acceptable (do they fulfil professionals’ needs?, use an indicator emanating from a recognised and accepted reference source?, is the work-load acceptable?). At the same time, they should describe the conditions under which the interpretations were made (threshold, need for risk stratification or other adjustments, the sample size) and the expected impact (magnitude of the quality parameters identified, detection of avoidable problems, measurement of identifiable corrective measures, impact of actions taken for improvement). Conclusion: The metric properties of the grid remain to be determined.
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