2017, Number 3
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salud publica mex 2017; 59 (3)
Implementation of quality of care indicators for third-level public hospitals in Mexico
Saturno-Hernández PJ, Martínez-Nicolás I, Poblano-Verástegui O, Vértiz-Ramírez JJ, Suárez-Ortiz EC, Magaña-Izquierdo M, Kawa-Karasik S
Language: Spanish
References: 29
Page: 227-235
PDF size: 261.78 Kb.
ABSTRACT
Objective. To select, pilot test and implement a set of indicators
for tertiary public hospitals.
Materials and methods.
Quali-quantitative study in four stages: identification of
indicators used internationally; selection and prioritization
by utility, feasibility and reliability; exploration of the quality
of sources of information in six hospitals; pilot feasibility
and reliability, and follow-up measurement.
Results. From
143 indicators, 64 were selected and eight were prioritized.
The scan revealed sources of information deficient. In the
pilot, three indicators were feasible with reliability limited.
Has conducted workshops to improve records and sources
of information; nine hospitals reported measurements of a
quarter.
Conclusions. Eight priority indicators could not be
measured immediately due to limitations in the data sources
for its construction. It is necessary to improve mechanisms of
registration and processing of data in this group of hospital.
REFERENCES
National Institute of Public Health and Secretariat of Health. Assessment of the National Health Information System of Mexico. Mexico: INSP, 2006.
Health Information System Work Group (Mesoamerican Health Initiative). Situational Analysis Report on Health Information System. Mexico, 2009.
Organization for Economic Co-operation and Development. Strengthening Health Information Infrastructure for Health Care Quality Governance. París: OECD Publishing, 2013. https://doi. org/10.1787/9789264193505-en
Organisation for Economic Co-operation and Development (OECD). OECD Reviews of Health Systems: Mexico 2016. París: OECD Publishing, 2016. https://doi.org/10.1787/9789264230491-en
Plaza B, Giusti A, Palacio-Mejía LS, Torres N, Reyes N. Regional Initiative in Health Information Systems Strengthening: Latin America and Caribbean 2005-2010. Chapel Hill: MEASURE Evaluation, 2012.
Saturno PJ, Gutiérrez J, Armendáriz DM, Armenta N, Candia E, Contreras D, et al. Calidad del primer nivel de atención de los servicios estatales de salud. Diagnóstico estratégico de la situación actual. Cuernavaca: INSP-BID, 2014.
Comisión Nacional de Evaluación de la Política de Desarrollo Social (Coneval). Diagnóstico de matrices de indicadores para resultados 2014. Ciudad de México: Coneval, 2015.
Rivera-Buendía F, Bello-Chavolla OY, Zubieta-Zavala A, Hernández- Ramírez L, Zepeda-Tena C, Durán-Arenas L. Evaluación de la implementación del programa Sicalidad en México. Salud Publica Mex 2015;57(4):329-334. https://doi.org/10.21149/spm.v57i4.7576
Centers for Medicare & Medicaid Services. Measures displayed on Hospital Compare [sitio en internet]. 2015 [consultado en enero de 2015]. Disponible en: https://www.medicare.gov/HospitalCompare/data/ measures-displayed.html#MC3
Organization for Economic Co-operation and Development (OECD). OECD Health Statistics 2015 [sitio en internet]. 2015 [consultado el 21 de enero de 2015]. Disponible en: http://www.oecd.org/els/healthsystems/ health-data.htm
Fink A, Kosecoff J, Chassin M, Brook RH. Consensus methods: Characteristics and guidelines for use. Am J Public Health 1984;74(9):979-983. https://doi.org/10.2105/AJPH.74.9.979
Saturno PJ, Martinez-Nicolas I, Robles-Garcia IS, López-Soriano F, Angel-García D. Development and pilot test of a new set of good practice indicators for chronic cancer pain management. Eur J Pain 2015;19(1):28- 38. https://doi.org/10.1002/ejp.516
Saturno P, Agüero L, Fernández M, Galván A, Poblano O, Rodriguez A, et al. Evaluación de guías de práctica clínica para el primer nivel de atención. Calidad formal y apego a las guías de práctica clínica sobre síndrome metabólico y salud materno-infantil. Cuernavaca: Instituto Nacional de Salud Pública, 2016.
Stelfox HT, Straus SE. Measuring quality of care: considering conceptual approaches to quality indicator development and evaluation. J Clin Epidemiol 2013;66(12):1328-1337. https://doi.org/10.1016/j.jclinepi.2013.05.017
Mainz J. Developing evidence-based clinical indicators: a state of the art methods primer. Int J Qual Health Care 2003;15(suppl 1):i5-i11. https:// doi.org/10.1093/intqhc/mzg084
Rubin HR, Pronovost P, Diette GB. From a process of care to a measure: the development and testing of a quality indicator. Int J Qual Health Care 2001;13(6):489-496. https://doi.org/10.1093/intqhc/13.6.489
Fleiss J. The Measurement of Interrater Agreement. In: Statistical Methods for Rates and Proportions. Hoboken, NJ, USA: John Wiley & Sons, Inc.,1982:598-626. https://doi.org/10.1002/0471445428.ch18
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33(1):159-174. https://doi. org/10.2307/2529310
Feinstein AR, Cicchetti D V. High agreement but low kappa: I. The problems of two paradoxes. J Clin Epidemiol 1990;43(6):543-549. https:// doi.org/10.1016/0895-4356(90)90158-L
Martínez-Nicolás I, Poblano-Verástegui O, Ramírez-Vértiz J de J, Saturno- Hernández PJ. Proyecto IAMAE: Priorización de indicadores y fichas técnicas desarrolladas. https://doi.org/10.6084/m9.figshare.4653433.v1
Jones J, Hunter D. Consensus methods for medical and health services research. BMJ 1995;311(7001):376-380. https://doi.org/10.2164/jandrol. 111.015065
Organization for Economic Co-operation and Development (OECD). Health Care Utilization, 2016 [documento en internet]. 2016 [consultado el 25 de julio de 2016]. Disponible en: http://stats.oecd.org/index. aspx?DatasetCode=HEALTH_PROC
Secretaría de Salud. Guía de práctica clínica: prevención, diagnóstico y tratamiento de las infecciones relacionadas con vías vasculares. México, Ciudad de México: CENETEC, 2012.
Centers for Medicare & Medicaid Services (CMS). Healthcare Associated Infections - Hospital [documento en internet]. 2016 [consultado en julio de 2016]. Disponible en: https://data.medicare.gov/Hospital-Compare/ Healthcare-Associated-Infections-Hospital/77hc-ibv8
Centers for Medicare & Medicaid Services (CMS). Timely and Effective Care - National. [documento en internet]. 2016 [consultado en agosto de 2016]. Disponible en: https://data.medicare.gov/Hospital-Compare/Timelyand- Effective-Care-National/isrn-hqyy
Secretaría de Salud. Dirección General de Calidad y Educación en Salud (DGCES). Sistema Nacional de Indicadores de Calidad en Salud (Indicas) [sitio en internet]. 2016 [consultado en julio de 2016]. Disponible en: http://dgces.salud.gob.mx/INDICASII/
Ministerio de Sanidad Servicios Sociales e Igualdad (MSSSI). Indicadores Clave del Sistema Nacional de Salud. Versión 1.0 [sitio en internet]. 2016. Disponible en: http://inclasns.msssi.es/
Saturno PJ, Gutiérrez JP, Armendáriz DM, Armenta N, Candia E, Contreras D, et al. Calidad del primer nivel de atención de los servicios estatales de salud. Propuesta de intervenciones. Cuernavaca: Instituto Nacional de Salud Pública, 2014.
Saturno PJ. Qué, cómo y cuándo monitorizar: marco conceptual y guía metodológica. Rev Calid Asist 1998;13:437-443.