gms | German Medical Science

16. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

4. - 6. Oktober 2017, Berlin

Development of cross-national quality indicators in countries of the Danube region

Meeting Abstract

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  • Isabell Großimlinghaus - LVR-Institut für Versorgungsforschung, Düsseldorf, Germany
  • Wolfgang Gaebel - LVR-Institut für Versorgungsforschung, Düsseldorf, Germany

16. Deutscher Kongress für Versorgungsforschung (DKVF). Berlin, 04.-06.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP175

doi: 10.3205/17dkvf366, urn:nbn:de:0183-17dkvf3662

Published: September 26, 2017

© 2017 Großimlinghaus et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background: There is an increasing pressure on national healthcare systems to provide adequate, high quality mental healthcare. However, standards of mental healthcare provision vary widely between European countries. A common concern for countries with mental healthcare systems under reform, like southeastern European countries in the Danube region, is to assess the quality of mental health care services using quality indicators with the aim to evaluate care structures, processes and outcomes. This poster presents the methodology and implications of a project on the development of cross-national quality indicators in countries of the Danube region (Bulgaria, Czech Republic, Hungary and Serbia).

Objective: How can cross-national quality indicators for mental health care in countries in the Danube region be developed in an evidence- and consensus-based way?

Method: Based on previous experiences from the systematic development of quality indicators for the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN), a structured evidence- and consensus-based development process was defined. Quality indicators are being developed as of April 2017 by a German project leader and in cooperation with country partners from Bulgaria, the Czech Republic, Hungary and Serbia.

Results: In order to identify a common ground between countries, a survey on the importance of mental healthcare quality domains, which are categorized into mental health care structures, processes and outcomes and which are differentiated between healthcare system-level (macro), institution-level (meso) and individual-level (micro) will be conducted. The survey addresses not only project partners but also other relevant stakeholders including therapeutic personnel with different profession as well as patient and care giver representatives. The results of the survey will give an overview on relevant quality domains in all countries and will reveal similarities and differences. In a further step, quality indicators will be identified for the respective quality domains. Further, a modified Delphi process will be conducted in which all quality indicators will be rated by means of predefined criteria. Between both Delphi rounds, a conference will be held in order to discuss the rating outcomes of the first round. Thereby, raters have the chance to evaluate their opinion and rerate indicators in a second round.

Discussion: In general, national healthcare systems differ in terms of their structures and organization. There are also differences in the way mental healthcare is delivered, and in the availability and priorities of health policies. This structured development process of quality indicators for countries in the Danube region will help to identify similar priorities of all countries in terms of how quality should be defined and which quality indicators should be assessed in order to improve quality of mental healthcare. Moreover, whereas the rating of quality indicators will include the criterion of “practicability”, it will be necessary to field test quality indicators in a further step in order to evaluate their actual practicability.

Practical implications: Quality indicators can be useful tools in order to identify the current development status of mental healthcare systems in each country and this study provides a feasible process on how to develop valid, feasible and practicable quality indicators. Assessment can provide incentives for transforming mental healthcare towards improving quality and effectiveness. However, these systematically developed quality indicators need to be properly disseminated across and within countries in order to improve acceptance of stakeholders and implementation. Finally, these quality indicators can help get political decision-makers attention for important quality domains.