title: Quality of care in chronic leg ulcer in the community: introduction of quality indicators and a scoring system.
abstract: BACKGROUND
  Treatment of chronic wounds is complex, particularly as a standard for the assessment and evaluation of quality of care is missing.
  
  
  OBJECTIVE
  To develop indicators for quality of care in chronic wounds in general, and to evaluate the quality of care in leg ulcers in Hamburg, Germany, in particular.
  
  
  METHODS
  Twenty indicators were derived from a national Delphi expert consensus to compute a single index of quality of care. This index was applied in a cross-sectional study involving a large spectrum of care providers and leg ulcer patients in the community. Trained wound experts interviewed and examined the patients, who had to complete standardized questionnaires.
  
  
  RESULTS
  On average, 64% of the quality criteria were met in the consecutive sample of 502 patients with chronic leg ulcers of any origin; 75% of the patients were satisfied with their wound care. Predictors of quality of care are presented.
  
  
  CONCLUSIONS
  This instrument is feasible, valid and ready for comparisons of patient groups, regions and care systems, and for optimization processes in wound care.
authors.affiliation: Center for Dermatological Research, Comprehensive Wound Center, Institute for Health Services Research in Dermatology and Nursing, University Clinics of Hamburg, Hamburg, Germany. m.augustin@uke.uni-hamburg.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
authors.forename: Stephan Jeff
authors.initials: SJ
authors.lastname: Rustenbach
authors.forename: Sebastian
authors.initials: S
authors.lastname: Debus
authors.forename: Lena
authors.initials: L
authors.lastname: Grams
authors.forename: Karl-Christian
authors.initials: KC
authors.lastname: Münter
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Tigges
authors.forename: Elmar
authors.initials: E
authors.lastname: Schäfer
authors.forename: Katharina
authors.initials: K
authors.lastname: Herberger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006801:Humans; D007871:Leg Ulcer / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019984:Quality Indicators, Health Care; D012107:Research Design; D014945:Wound Healing; D055815:Young Adult