Abstract
Introduction
The ultimate purpose of measuring quality of care is to discriminate between healthcare providers in order to motivate improvement. Recently, a set of evidence-based indicators has been proposed for measurement of processes of care for patients with cirrhosis, for example early endoscopy for variceal bleeding. The objective of this study was to determine whether these indicators can be measured in a reliable and automated fashion in routine practice.
Materials and methods
We applied the top five indicators, based on agreement of a panel of experts, to hospitalized adults at our institution over a 3-year period.
Results
Only two of the indicators could be reliably measured on the basis of the published wording, and these two still required physician chart review. After applying some assumptions, the indicators were met in 46–100% of cases. None of the indicators was linked to a single physician or institution in all cases, and none occurred with sufficient frequency to discriminate quality between providers.
Conclusion
Measuring quality of care in cirrhosis is a laudable objective, but current indicators are not yet ready for administrative use.
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Abbreviations
- SBP:
-
Spontaneous bacterial peritonitis
- PMN:
-
Polymorphonuclear
- UGIB:
-
Upper gastrointestinal bleeding
- EVL:
-
Endoscopic variceal ligation
- MAR:
-
Medication administration record
- EGD:
-
Esophagogastroduodenoscopy
- TIPS:
-
Transjugular intrahepatic portosystemic shunt
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Acknowledgments
The authors received grant support from NIH K23DK085204 (MLV).
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Bassett, J.T., Volk, M.L. Can Quality of Care for Patients with Cirrhosis Be Measured?. Dig Dis Sci 56, 3488–3491 (2011). https://doi.org/10.1007/s10620-011-1805-9
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DOI: https://doi.org/10.1007/s10620-011-1805-9