Evaluation of quality of care and guideline-compliant treatment in psoriasis. Development of a new system of quality indicators.
BACKGROUND
To date, no standardised indicators for quality of care in psoriasis have been published.


OBJECTIVE
Development and testing of evidence-based indicators of quality of care and guideline compliance in the treatment of psoriasis.


METHODS
Indicators of process and outcome quality were extracted and evaluated in a Delphi process according to international standards. The primary reference was the S3 German guideline for psoriasis treatment. The indicators were validated with data from two nationwide studies on psoriasis care involving 1,511 and 2,009 patients.


RESULTS
Eight quality indicators were defined: mean PASI, mean quality of life (Dermatology Life Quality Index; DLQI), proportion of patients with PASI >20, with DLQI >10, with previous systemic treatment, with PASI >20 and systemic treatment, with inpatient treatment, and number of work days lost. All indicators proved suitable for application, and were sensitive to change.


CONCLUSIONS
Guideline-based indicators of quality of care are useful in the analysis of health care and the implementation of treatment guidelines in psoriasis.
German Center for Health Services Research in Dermatology (CVderm), Department of Dermatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. m.radtke@uke.uni-hamburg.de
M A
MA
Radtke
K
K
Reich
C
C
Blome
I
I
Kopp
S J
SJ
Rustenbach
I
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Schäfer
M
M
Augustin
D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D017410:Practice Guidelines as Topic; D011565:Psoriasis / Q000473:pathology / Q000628:therapy*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D011788:Quality of Life