Routine data-based quality indicators for the treatment of gonarthrosis and coxarthrosis patients in the ambulatory care sector – A study protocol for a cluster-randomised pilot trial to evaluate the MobilE-ARTH study
Abstract Background In 2019, Germany had the highest rate of hip replacement surgery and the fourth highest rate of knee replacement surgery among more than 30 OECD countries. The age-standardised rates were estimated at 174 hip joint and 137 knee joint replacements per 100,000 population. Against t...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-05699-7 |
| _version_ | 1818505156145184768 |
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| author | Tobias Bock Ronja Flemming Wiebke Schüttig Anja Schramm Martin B. Weigl Leonie Sundmacher |
| author_facet | Tobias Bock Ronja Flemming Wiebke Schüttig Anja Schramm Martin B. Weigl Leonie Sundmacher |
| author_sort | Tobias Bock |
| collection | DOAJ |
| description | Abstract Background In 2019, Germany had the highest rate of hip replacement surgery and the fourth highest rate of knee replacement surgery among more than 30 OECD countries. The age-standardised rates were estimated at 174 hip joint and 137 knee joint replacements per 100,000 population. Against this background, the contrast between financial incentives for surgery and missing incentives for non-surgical treatment options is repeatedly discussed. Quality indicators (QIs) can serve to measure and transparently present the quality of evidence-based care. Comparing results in the form of audit and feedback has been shown to improve e.g. guideline-compliant ambulatory care. Existing QIs targeting the care of gon- and coxarthrosis mainly focus on discharge management after joint replacement surgery and/or require additional data collection. Therefore, as part of the MobilE-ARTH project, a set of QIs for ambulatory care prior to joint replacement surgery calculable based on routine data is being developed. The present study’s aim is to evaluate the impact of this QI set in terms of providing feedback on the quality of care. Methods The MobilE-ARTH project comprises (Phase 1) developing a QI set following the RAND/UCLA Appropriateness Method, (Phase 2) implementing the QIs in established physician networks of a German statutory health insurance (SHI) within a prospective, non-blinded, cluster-randomised pilot study, and (Phase 3) evaluating the QI set’s effectiveness. The physicians in the intervention networks will (a) receive feedback reports providing information about the routine data-based QIs of their gon- and/or coxarthrosis patients and aggregated results for their network, and (b) be invited to two voluntary, facilitated network meetings. In these network meetings, the physicians can use the information provided on the feedback reports to discuss multiprofessional care pathways for patients with gon- and/or coxarthrosis. Selected indicators of the QI set will serve as primary and secondary outcome measures. Routine data will be analysed within multi-level models using an intention-to-treat approach. Discussion Feedback reports help maintaining clinical standards and closing the gap between evidence and medical practice, thus enabling an overall improvement in health care. Providing physicians with QI-based information on quality of care promotes identifying strengths and weaknesses in medical treatments. Trial registration German Clinical Trials Register, number DRKS00027516 , Registered 25th January 2022 – Prospectively registered. |
| first_indexed | 2024-12-10T21:46:57Z |
| format | Article |
| id | doaj.art-c41b882cde484f9c8d9c6dd57ee26df1 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-10T21:46:57Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-c41b882cde484f9c8d9c6dd57ee26df12022-12-22T01:32:21ZengBMCBMC Musculoskeletal Disorders1471-24742022-08-012311810.1186/s12891-022-05699-7Routine data-based quality indicators for the treatment of gonarthrosis and coxarthrosis patients in the ambulatory care sector – A study protocol for a cluster-randomised pilot trial to evaluate the MobilE-ARTH studyTobias Bock0Ronja Flemming1Wiebke Schüttig2Anja Schramm3Martin B. Weigl4Leonie Sundmacher5Chair of Health Economics, Department of Sport and Health Sciences, Technical University of Munich (TUM)Chair of Health Economics, Department of Sport and Health Sciences, Technical University of Munich (TUM)Chair of Health Economics, Department of Sport and Health Sciences, Technical University of Munich (TUM)Department of Analytics and Data, AOK Bavaria – The health insurance fundDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Centre Munich (MUM), University Hospital, Ludwig Maximilian University of Munich (LMU)Chair of Health Economics, Department of Sport and Health Sciences, Technical University of Munich (TUM)Abstract Background In 2019, Germany had the highest rate of hip replacement surgery and the fourth highest rate of knee replacement surgery among more than 30 OECD countries. The age-standardised rates were estimated at 174 hip joint and 137 knee joint replacements per 100,000 population. Against this background, the contrast between financial incentives for surgery and missing incentives for non-surgical treatment options is repeatedly discussed. Quality indicators (QIs) can serve to measure and transparently present the quality of evidence-based care. Comparing results in the form of audit and feedback has been shown to improve e.g. guideline-compliant ambulatory care. Existing QIs targeting the care of gon- and coxarthrosis mainly focus on discharge management after joint replacement surgery and/or require additional data collection. Therefore, as part of the MobilE-ARTH project, a set of QIs for ambulatory care prior to joint replacement surgery calculable based on routine data is being developed. The present study’s aim is to evaluate the impact of this QI set in terms of providing feedback on the quality of care. Methods The MobilE-ARTH project comprises (Phase 1) developing a QI set following the RAND/UCLA Appropriateness Method, (Phase 2) implementing the QIs in established physician networks of a German statutory health insurance (SHI) within a prospective, non-blinded, cluster-randomised pilot study, and (Phase 3) evaluating the QI set’s effectiveness. The physicians in the intervention networks will (a) receive feedback reports providing information about the routine data-based QIs of their gon- and/or coxarthrosis patients and aggregated results for their network, and (b) be invited to two voluntary, facilitated network meetings. In these network meetings, the physicians can use the information provided on the feedback reports to discuss multiprofessional care pathways for patients with gon- and/or coxarthrosis. Selected indicators of the QI set will serve as primary and secondary outcome measures. Routine data will be analysed within multi-level models using an intention-to-treat approach. Discussion Feedback reports help maintaining clinical standards and closing the gap between evidence and medical practice, thus enabling an overall improvement in health care. Providing physicians with QI-based information on quality of care promotes identifying strengths and weaknesses in medical treatments. Trial registration German Clinical Trials Register, number DRKS00027516 , Registered 25th January 2022 – Prospectively registered.https://doi.org/10.1186/s12891-022-05699-7GonarthrosisCoxarthrosisQuality indicatorsQuality of careAmbulatory careNetworks |
| spellingShingle | Tobias Bock Ronja Flemming Wiebke Schüttig Anja Schramm Martin B. Weigl Leonie Sundmacher Routine data-based quality indicators for the treatment of gonarthrosis and coxarthrosis patients in the ambulatory care sector – A study protocol for a cluster-randomised pilot trial to evaluate the MobilE-ARTH study BMC Musculoskeletal Disorders Gonarthrosis Coxarthrosis Quality indicators Quality of care Ambulatory care Networks |
| title | Routine data-based quality indicators for the treatment of gonarthrosis and coxarthrosis patients in the ambulatory care sector – A study protocol for a cluster-randomised pilot trial to evaluate the MobilE-ARTH study |
| title_full | Routine data-based quality indicators for the treatment of gonarthrosis and coxarthrosis patients in the ambulatory care sector – A study protocol for a cluster-randomised pilot trial to evaluate the MobilE-ARTH study |
| title_fullStr | Routine data-based quality indicators for the treatment of gonarthrosis and coxarthrosis patients in the ambulatory care sector – A study protocol for a cluster-randomised pilot trial to evaluate the MobilE-ARTH study |
| title_full_unstemmed | Routine data-based quality indicators for the treatment of gonarthrosis and coxarthrosis patients in the ambulatory care sector – A study protocol for a cluster-randomised pilot trial to evaluate the MobilE-ARTH study |
| title_short | Routine data-based quality indicators for the treatment of gonarthrosis and coxarthrosis patients in the ambulatory care sector – A study protocol for a cluster-randomised pilot trial to evaluate the MobilE-ARTH study |
| title_sort | routine data based quality indicators for the treatment of gonarthrosis and coxarthrosis patients in the ambulatory care sector a study protocol for a cluster randomised pilot trial to evaluate the mobile arth study |
| topic | Gonarthrosis Coxarthrosis Quality indicators Quality of care Ambulatory care Networks |
| url | https://doi.org/10.1186/s12891-022-05699-7 |
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