title: Indicators for childhood asthma in Spain, using the Rand method.
abstract: OBJECTIVE
  To develop quality indicators to measure asthma care in primary health care.
  
  
  METHODS
  A modified RAND was used, which included the systematic review of the literature in Embase, Cochrane and Pubmed Quality Agencies and Database. The work group identified the indicators, translated them into Spanish and resolved any duplicates. Each indicator is composed of several dimensions (access to care, clinical effectiveness, patient-centred quality and patient safety). A multidisciplinary panel of 98 professionals from all over Spain were invited to score each indicator using a Likert scale. After calculating the average and median of each indicator, this information was sent to those who responded (n=38) for a second round and further scoring. The agreement percentage for the group was obtained for each indicator.
  
  
  RESULTS
  Of the 105 asthma indicators reviewed, we selected 46 that were presented to the panel of experts. In both Delphi phases, 37.1% of the members of the initial panel of experts responded. Of these, 26 were primary care paediatricians, six were pulmonologists, three were nurses, two were pharmacists and one was an allergist. For 32 indicators, agreement exceeded 70% and seven of those scored highest for the various care aspects for asthmatic children.
  
  
  CONCLUSIONS
  Quality indicators are presented for the follow-up of asthma and their implementation in primary care, which have undergone a strict selection and agreement process by a multidisciplinary work group.
authors.affiliation: Centro de Salud Virgen de África, Seville, Spain. Electronic address: jruizcanela@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Ruiz-Canela-Cáceres
authors.affiliation: Universidad Pablo Olavide, Seville, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Aquino-Llinares
authors.affiliation: Hospital Universitario Virgen Macarena, Seville, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Sánchez-Diaz
authors.affiliation: Centro de Salud Puerta Este, Seville, Spain.
authors.forename: M L
authors.initials: ML
authors.lastname: García-Gestoso
authors.affiliation: Centro de Salud Torreblanca, Seville, Spain.
authors.forename: M E
authors.initials: ME
authors.lastname: de Jaime-Revuelta
authors.affiliation: Centro de Salud La Candelaria, Universidad de Sevilla, Seville, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Praena-Crespo
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D032921:Consensus; D003697:Delphi Technique; D005104:Expert Testimony; D006297:Health Services Accessibility; D006801:Humans; D033183:Interdisciplinary Communication; D061214:Patient Safety; D018802:Patient-Centered Care; D011320:Primary Health Care / Q000379:methods; D019984:Quality Indicators, Health Care; D013030:Spain; D016896:Treatment Outcome
keywords: Asthma; Emergencies; Guidelines; Nebulizers and vaporizers; Patient education; Primary health care; Quality indicators, health care; Risk factors; Severity of illness