Development of quality of care indicators for Parkinson's disease.
Parkinson's disease (PD) is a major cause of disability. To date, there have been no large-scale efforts to measure the quality of PD care because of a lack of quality indicators for conducting an explicit review of PD care processes. We present a set of quality indicators for PD care. Based on a structured review of the medical literature, 79 potential indicators were drafted. Through a two-round modified Delphi process, an expert panel of seven movement disorders specialists rated each indicator on criteria of validity, feasibility, impact on outcomes, room for improvement, and overall utility. Seventy-one quality indicators met validity and feasibility thresholds. Applying thresholds for impact on outcomes, room for improvement, and overall utility, a subset of 29 indicators was identified, spanning dopaminergic therapy, assessment of functional status, assessment and treatment of depression, coordination of care, and medication use. Multivariable analysis showed that overall utility ratings were driven by validity and impact on outcomes (P < 0.01). An expert panel can reach consensus on a set of highly rated quality indicators for PD care, which can be used to assess quality of PD care and guide the design of quality improvement projects.
Parkinson's Disease Research, Education Clinical Center (PADRECC), Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA. eric.cheng@med.va.gov
Eric M
EM
Cheng
Andrew
A
Siderowf
Kari
K
Swarztrauber
Mahmood
M
Eisa
Martin
M
Lee
Barbara G
BG
Vickrey
D000203:Activities of Daily Living; D019091:Critical Pathways / Q000706:statistics & numerical data*; D005104:Expert Testimony; D005240:Feasibility Studies; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000592:standards; D010300:Parkinson Disease / Q000628:therapy*; D019984:Quality Indicators, Health Care / Q000592:standards*; D011788:Quality of Life; D015203:Reproducibility of Results; D013038:Specialization