Measuring quality in arthritis care: methods for developing the Arthritis Foundation's quality indicator set.
OBJECTIVE
To develop a comprehensive set of explicit process measures to assess the quality of health care for osteoarthritis, rheumatoid arthritis, and analgesics use.


METHODS
Potential quality measures and a summary of existing data to support or refute the relationship between the processes of care proposed in the indicators and relevant clinical outcomes were developed through a comprehensive literature review. The proposed measures and literature summary were presented to a multidisciplinary panel of experts in arthritis and pain. Using a modification of the RAND/UCLA Appropriateness Method, the panel rated each proposed measure for its validity as a measure of health care quality.


RESULTS
Among 66 proposed indicators, the expert panel rated 51 as valid measures of health care including 14 for osteoarthritis, 27 for rheumatoid arthritis, and 10 for analgesics use.


CONCLUSIONS
Sufficient scientific evidence and expert consensus exist to support a comprehensive set of measures to assess the quality of heath care for osteoarthritis, rheumatoid arthritis, and analgesics use. These measures can be used to gain an understanding of the quality of care for patients with arthritis.
MacLean
Catherine H
CH
RAND Corporation, Santa Monica, California and University of California Los Angeles School of Medicine, USA. maclean@rand.org
Saag
Kenneth G
KG
Solomon
Daniel H
DH
Morton
Sally C
SC
Sampsel
Sarah
S
Klippel
John H
JH
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005582:Foundations; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy*; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000379:methods*; D012219:Rheumatology / Q000592:standards*
D000894:Anti-Inflammatory Agents, Non-Steroidal