title: Self-reported quality care for knee osteoarthritis: comparisons across Denmark, Norway, Portugal and the UK.
abstract: OBJECTIVE
  To assess and compare patient perceived quality of osteoarthritis (OA) management in primary healthcare in Denmark, Norway, Portugal and the UK.
  
  
  METHODS
  Participants consulting with clinical signs and symptoms of knee OA were identified in 30 general practices and invited to complete a cross-sectional survey including quality indicators (QI) for OA care. A QI was considered as eligible if the participant had checked 'Yes' or 'No', and as achieved if the participant had checked 'Yes' to the indicator. The median percentage (with IQR and range) of eligible QIs achieved by country was determined and compared in negative binominal regression analysis. Achievement of individual QIs by country was determined and compared using logistic regression analyses.
  
  
  RESULTS
  A total of 354 participants self-reported QI achievement. The median percentage of eligible QIs achieved (checked 'Yes') was 48% (IQR 28%, 64%; range 0-100%) for the total sample with relatively similar medians across three of four countries. Achievement rates on individual QIs showed a large variation ranging from 11% (referral to services for losing weight) to 67% (information about the importance of exercise) with significant differences in achievement rates between the countries.
  
  
  CONCLUSIONS
  The results indicated a potential for improvement in OA care in all four countries, but for somewhat different aspects of OA care. By exploring these differences and comparing healthcare services, ideas may be generated on how the quality might be improved across nations. Larger studies are needed to confirm and further explore the findings.
authors.affiliation: National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway.
authors.forename: N
authors.initials: N
authors.lastname: Østerås
authors.affiliation: Arthritis Research UK, Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University , Staffordshire , UK.
authors.forename: K P
authors.initials: KP
authors.lastname: Jordan
authors.affiliation: Research Unit for Musculoskeletal Function and Physiotherapy , Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark , Odense , Denmark.
authors.forename: B
authors.initials: B
authors.lastname: Clausen
authors.affiliation: Faculty of Science and Technology and Centre for Research and Development in Health (CESUAlg) , University of Algarve , Faro , Portugal ; Centre of Statistics and Applications (CEAUL), University of Lisbon , Lisbon , Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Cordeiro
authors.affiliation: Arthritis Research UK, Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University , Staffordshire , UK.
authors.forename: K
authors.initials: K
authors.lastname: Dziedzic
authors.affiliation: Arthritis Research UK, Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University , Staffordshire , UK.
authors.forename: J
authors.initials: J
authors.lastname: Edwards
authors.affiliation: National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway.
authors.forename: G
authors.initials: G
authors.lastname: Grønhaug
authors.affiliation: Arthritis Research UK, Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University , Staffordshire , UK.
authors.forename: A
authors.initials: A
authors.lastname: Higginbottom
authors.affiliation: Research Unit for Musculoskeletal Function and Physiotherapy , Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark , Odense , Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Lund
authors.affiliation: School of Health (ESSUAlg), University of Algarve , Faro , Portugal.
authors.forename: G
authors.initials: G
authors.lastname: Pacheco
authors.affiliation: School of Health (ESSUAlg), University of Algarve , Faro , Portugal ; Centre for Research and Development in Health (CESUAlg), University of Algarve , Faro , Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Pais
authors.affiliation: National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway.
authors.forename: K B
authors.initials: KB
authors.lastname: Hagen
keywords: Health services research; Osteoarthritis; Patient perspective; Quality Indicators