Quality indicator framework for primary care of patients with dementia

[摘要] Objective To develop a framework of population-based primary care qualityindicators adapted to patients with dementia and to identify a subset ofstakeholder-driven priority indicators.Design Framework development was carried out through the selection ofan initial framework based on a rapid review and identification of relevantindicators and enrichment based on existing dementia indicators and guidelines.Prioritization of indicators was carried out through a stakeholder survey.Setting Ontario, Quebec, New Brunswick, and Saskatchewan.Participants Stakeholders in community dementia care (N=109) includingclinicians, patients, caregivers, decision makers, and managers.Main outcome measures Primary care quality indicators.Results The framework comprised 34 indicators across 8 domains of quality(access, integration, effective care, efficient care, equity, safety, populationhealth, and patient-centred care). Access to a regular primary care provider,continuity of care, early-stage diagnosis, and access to home care wereconsistently rated as priorities. Equitable care was a specific priority amongpatients and caregivers; clinicians reported avoidable hospitalizations asamong their priorities.Conclusion A framework of indicators was established for persons withdementia that adds an important dimension to existing primary care anddementia quality indicators by providing primary care and populationbased perspectives. This framework could set a foundation for the ongoingmonitoring of primary care practices and policies for persons with dementia ata population level.

[学科分类] 卫生学