dc.contributor.author | de Wet, Carl | |
dc.contributor.author | McKay, John | |
dc.contributor.author | Bowie, Paul | |
dc.date.accessioned | 2018-10-23T12:31:46Z | |
dc.date.available | 2018-10-23T12:31:46Z | |
dc.date.issued | 2012 | |
dc.identifier.issn | 1472-6963 | |
dc.identifier.doi | 10.1186/1472-6963-12-351 | |
dc.identifier.uri | http://hdl.handle.net/10072/340650 | |
dc.description.abstract | Background: A significant minority of patients do not receive all the evidence-based care recommended for their
conditions. Health care quality may be improved by reducing this observed variation. Composite measures offer a
different patient-centred perspective on quality and are utilized in acute hospitals via the ‘care bundle’ concept as
indicators of the reliability of specific (evidence-based) care delivery tasks and improved outcomes. A care bundle
consists of a number of time-specific interventions that should be delivered to every patient every time. We aimed
to apply the care bundle concept to selected QOF data to measure the quality of evidence-based care provision.
Methods: Care bundles and components were selected from QOF indicators according to defined criteria. Five
clinical conditions were suitable for care bundles: Secondary Prevention of Coronary Heart Disease (CHD), Stroke &
Transient Ischaemic Attack (TIA), Chronic Kidney Disease (CKD), Chronic Obstructive Pulmonary Disease (COPD) and
Diabetes Mellitus (DM). Each bundle has 3-8 components. A retrospective audit was undertaken in a convenience
sample of nine general medical practices in the West of Scotland. Collected data included delivery (or not) of
individual bundle components to all patients included on specific disease registers. Practice level and overall
compliance with bundles and components were calculated in SPSS and expressed as a percentage.
Results: Nine practices (64.3%) with a combined patient population of 56,948 were able to provide data in the
format requested. Overall compliance with developed QOF-based care bundles (composite measures) was as
follows: CHD 64.0%, range 35.0-71.9%; Stroke/TIA 74.1%, range 51.6-82.8%; CKD 69.0%, range 64.0-81.4%; and COPD
82.0%, range 47.9-95.8%; and DM 58.4%, range 50.3-65.2%.
Conclusions: In this small study compliance with individual QOF-based care bundle components was high, but
overall (‘all or nothing’) compliance was substantially lower. Care bundles may provide a more informed measure of
care quality than existing methods. However, the acceptability, feasibility and potential impact on clinical outcomes
are unknown | |
dc.description.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | BioMed Central | |
dc.relation.ispartofpagefrom | 351-1 | |
dc.relation.ispartofpageto | 351-11 | |
dc.relation.ispartofissue | 1 | |
dc.relation.ispartofjournal | BMC Health Services Research | |
dc.relation.ispartofvolume | 12 | |
dc.subject.fieldofresearch | Library and information studies | |
dc.subject.fieldofresearch | Nursing | |
dc.subject.fieldofresearchcode | 4610 | |
dc.subject.fieldofresearchcode | 4205 | |
dc.title | Combining QOF data with the care bundle approach may provide a more meaningful measure of quality in general practice | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dc.type.code | C - Journal Articles | |
dcterms.license | http://creativecommons.org/licenses/by/2.0 | |
dc.description.version | Version of Record (VoR) | |
gro.description.notepublic | Page numbers are not for citation purposes. Instead, this article has the unique article number of 351. | |
gro.rights.copyright | © de Wet et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. | |
gro.hasfulltext | Full Text | |
gro.griffith.author | de Wet, Carl | |