Abstract
Background: The prevalence of chronic kidney disease (CKD) has recently increased, and maintaining high quality of CKD care is a major factor in preventing end-stage renal disease. Here, we developed novel quality indicators for CKD care based on existing electronic health data. Methods: We used a modified RAND appropriateness method to develop quality indicators for the care of non-dialysis CKD patients, by combining expert opinion and scientific evidence. A multidisciplinary expert panel comprising six nephrologists, two primary care physicians, one diabetes specialist, and one rheumatologist assessed the appropriateness of potential indicators extracted from evidence-based clinical guidelines, in accordance with predetermined criteria. We developed novel quality indicators through a four-step process: selection of potential indicators, first questionnaire round, face-to-face meeting, and second questionnaire round. Results: Ten expert panel members evaluated 19 potential indicators in the first questionnaire round, of which 7 were modified, 12 deleted, and 4 newly added during subsequent face-to-face meetings, giving a final total of 11 indicators. Median rate of these 11 indicators in the final set was at least 7, and percentages of agreement exceeded 80 % for all but one indicator. All indicators in the final set can be measured using only existing electronic health data, without medical record review, and 9 of 11 are process indicators. Conclusion: We developed 11 quality indicators to assess quality of care for non-dialysis CKD patients. Strengths of the developed indicators are their applicability in a primary care setting, availability in daily practice, and emphasis on modifiable processes.
| Original language | English |
|---|---|
| Pages (from-to) | 1-10 |
| Number of pages | 10 |
| Journal | Clinical and Experimental Nephrology |
| DOIs | |
| Publication status | Accepted/In press - May 4 2016 |
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Keywords
- Administrative claims data
- Chronic kidney disease
- Quality indicators
- Quality of care
- RAND
ASJC Scopus subject areas
- Nephrology
- Physiology
- Physiology (medical)
Cite this
Development of quality indicators for care of chronic kidney disease in the primary care setting using electronic health data : a RAND-modified Delphi method. / Fukuma, Shingo; Shimizu, Sayaka; Niihata, Kakuya; Sada, Kenei; Yanagita, Motoko; Hatta, Tsuguru; Nangaku, Masaomi; Katafuchi, Ritsuko; Fujita, Yoshiro; Koizumi, Junji; Koizumi, Shunzo; Kimura, Kenjiro; Fukuhara, Shunichi; Shibagaki, Yugo.
In: Clinical and Experimental Nephrology, 04.05.2016, p. 1-10.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Development of quality indicators for care of chronic kidney disease in the primary care setting using electronic health data
T2 - a RAND-modified Delphi method
AU - Fukuma, Shingo
AU - Shimizu, Sayaka
AU - Niihata, Kakuya
AU - Sada, Kenei
AU - Yanagita, Motoko
AU - Hatta, Tsuguru
AU - Nangaku, Masaomi
AU - Katafuchi, Ritsuko
AU - Fujita, Yoshiro
AU - Koizumi, Junji
AU - Koizumi, Shunzo
AU - Kimura, Kenjiro
AU - Fukuhara, Shunichi
AU - Shibagaki, Yugo
PY - 2016/5/4
Y1 - 2016/5/4
N2 - Background: The prevalence of chronic kidney disease (CKD) has recently increased, and maintaining high quality of CKD care is a major factor in preventing end-stage renal disease. Here, we developed novel quality indicators for CKD care based on existing electronic health data. Methods: We used a modified RAND appropriateness method to develop quality indicators for the care of non-dialysis CKD patients, by combining expert opinion and scientific evidence. A multidisciplinary expert panel comprising six nephrologists, two primary care physicians, one diabetes specialist, and one rheumatologist assessed the appropriateness of potential indicators extracted from evidence-based clinical guidelines, in accordance with predetermined criteria. We developed novel quality indicators through a four-step process: selection of potential indicators, first questionnaire round, face-to-face meeting, and second questionnaire round. Results: Ten expert panel members evaluated 19 potential indicators in the first questionnaire round, of which 7 were modified, 12 deleted, and 4 newly added during subsequent face-to-face meetings, giving a final total of 11 indicators. Median rate of these 11 indicators in the final set was at least 7, and percentages of agreement exceeded 80 % for all but one indicator. All indicators in the final set can be measured using only existing electronic health data, without medical record review, and 9 of 11 are process indicators. Conclusion: We developed 11 quality indicators to assess quality of care for non-dialysis CKD patients. Strengths of the developed indicators are their applicability in a primary care setting, availability in daily practice, and emphasis on modifiable processes.
AB - Background: The prevalence of chronic kidney disease (CKD) has recently increased, and maintaining high quality of CKD care is a major factor in preventing end-stage renal disease. Here, we developed novel quality indicators for CKD care based on existing electronic health data. Methods: We used a modified RAND appropriateness method to develop quality indicators for the care of non-dialysis CKD patients, by combining expert opinion and scientific evidence. A multidisciplinary expert panel comprising six nephrologists, two primary care physicians, one diabetes specialist, and one rheumatologist assessed the appropriateness of potential indicators extracted from evidence-based clinical guidelines, in accordance with predetermined criteria. We developed novel quality indicators through a four-step process: selection of potential indicators, first questionnaire round, face-to-face meeting, and second questionnaire round. Results: Ten expert panel members evaluated 19 potential indicators in the first questionnaire round, of which 7 were modified, 12 deleted, and 4 newly added during subsequent face-to-face meetings, giving a final total of 11 indicators. Median rate of these 11 indicators in the final set was at least 7, and percentages of agreement exceeded 80 % for all but one indicator. All indicators in the final set can be measured using only existing electronic health data, without medical record review, and 9 of 11 are process indicators. Conclusion: We developed 11 quality indicators to assess quality of care for non-dialysis CKD patients. Strengths of the developed indicators are their applicability in a primary care setting, availability in daily practice, and emphasis on modifiable processes.
KW - Administrative claims data
KW - Chronic kidney disease
KW - Quality indicators
KW - Quality of care
KW - RAND
UR - http://www.scopus.com/inward/record.url?scp=84965071632&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84965071632&partnerID=8YFLogxK
U2 - 10.1007/s10157-016-1274-8
DO - 10.1007/s10157-016-1274-8
M3 - Article
C2 - 27145768
AN - SCOPUS:84965071632
SP - 1
EP - 10
JO - Clinical and Experimental Nephrology
JF - Clinical and Experimental Nephrology
SN - 1342-1751
ER -