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Measurement in Healthcare: the German Experience

Measurement in Healthcare: the German Experience. Burkhard Fischer, BQS, Düsseldorf, Germany 05.03.2009 Prague. Main performance and quality indicators measured. 26 measurement areas, 194 evidence-based QI covering indication, process, and outcome

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Measurement in Healthcare: the German Experience

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  1. Measurement in Healthcare: the German Experience Burkhard Fischer, BQS, Düsseldorf, Germany 05.03.2009 Prague

  2. Main performance and quality indicators measured • 26 measurement areas, 194 evidence-based QI • covering indication, process, and outcome • per-case electronic data capture (self-reported) • based on software specification (integrated into HIS) • patients: 3.590.000 (96,6%) • hospitals: 1.605 von 1.634 (98,2%) • source data validation (random sample) • individual comparative benchmarking reports • BQS Outcome, BQS Quality Report, BQS for Patients • Structured Dialogue, regional benchmarking

  3. Main performance and quality indicators measured for healthcare professionals for patients

  4. 1. quality of quality indicators

  5. BQS Quality Indicators 2007 regional benchmarking

  6. Key lessons learned • use evidence-based, risk-adjusted quality indicators • mandate an independent leading organisation • involve stakeholders incl. patients • limit the data collection burden • make measurement mandatory, remunerate providers • use administrative routine data were available, suitable and valid (e.g. DRG, ICD-10, procedure codes) • give timely feedback, work on the results (Str. Dialogue) • check appropriateness for public disclosure (QUALIFY)! • be aware of publication bias!

  7. 1. quality of quality indicators 2. acceptability for public disclosure

  8. assessed by QUALIFY instrument Komb. Koron.- u. Aortenkl.Chir. Knie-TEP-Erstimplantation Hüft-TEP-Erstimplantation Pneumoinie HSM Aggregatwechsel Hüftgelenknahe Femurfaktur Gynäkologische Op. HSM-Revision/-Explantation Knie-TEP-Wechsel with lay understandable texts PCI Dekubitusprophylaxe HSM-Implantation Karotis-Rekonstruktion Aortenklappen Nierenlebendspende Nierentransplantation Hüft-TEP-Wechsel Lebertransplantation Leberlebendspende Herztransplantation Koronarchirurgie, isoliert Mammachirurgie Cholezystektomie Geburtshilfe BQS Quality Indicators 2007 acceptable for public diclosure

  9. Next steps • Quality Measurement • along hole care healthcare provision process (out-patient / in-patient) • increased use of administrative routine data (DRG, diagnoses and procedures) • increased use area indicators • inclusion of chronic diseases • Quality Management • peer review programmes • expansion of public disclosure • introduction of selective contracting • pay for performance(?) • Support patient’s choice • results to be published by new national quality institute • lay understandable language and presentation

  10. Contact and Further Information Contact BQS Bundesgeschäftsstelle Qualitätssicherung (National Agency for Quality Measurement in Healthcare) Kanzlerstr. 4, D-40472 Düsseldorf, Germany info@bqs-online.de - www.bqs-online.de Further information QUALIFY instrument http://www.bqs-qualify.com/?set_language=en&cl=en BQS Indicators www.bqs-qualitaetsindikatoren.de BQS for Patients http://www.bqs-online.com/public/bqsfp/qifp Results www.bqs-outcome.de BQS Quality Reports www.bqs-qualitaetsreport.de

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