Expertos recomiendan establecer indicadores comunes para valorar la incidencia del ictus en Europa

Título: Variations in Quality Indicators of Acute Stroke Care in 6 European Countries The European Implementation Score (EIS) Collaboration

Resumen :

Background and Purpose : Quality indicators serve as standards of care by which performance of individual hospitals is measured. Although several audits for monitoring quality of stroke care have been established in Europe, there is currently no consensus on quality indicators for acute stroke care or for methodology for collecting information on these measures.

Methods : An up-to-date inventory on European stroke audits in place in 2006 was performed in the course of a project funded by the European Union (European Implementation Score Collaboration [EIS]). Two regional (Flanders, Belgium; Catalonia, Spain) and 4 national (Germany, Scotland, Sweden, England/Wales/Northern Ireland) stroke audits took part. Between November 2009 and July 2010, 2 standardized surveys and a series of interviews were performed to determine characteristics, methods, and content of these quality initiatives. For quality purposes, all summarized information was validated by representatives of the respective audits.

Results : Overall, 123 quality indicators (91 process, 24 outcome, and 8 structural indicators) were identified. Anticoagulants in patients with atrial fibrillation and brain imaging were the only quality indicators used in all, whereas another 13 indicators were used in at least 2 of the quality initiatives. Substantial variations were found across the audits in terms of the development process of quality indicators, inclusion criteria, participation, population coverage, data documentation, follow-ups, benchmarking, and feedback of results to participants.

Conclusions : There is a huge variety in measuring performance of acute stroke care in Europe, hampering valid comparisons of acute stroke care. Common standards for defining quality indicators and collecting information required for these measures should be defined in Europe.

Autores : Wiedmann, S.; Norrving, B.; Nowe, T.; Abilleira, S.; Asplund, K.; Dennis, M.; Hermanek, P.; Rudd, A.; Thijs, V.; Wolfe, C.D.A.; Heuschmann, P.U.

Direcciones :

1. Universidad de Wurzburg, Inst Clin Epidemiol & Biometry (Wurzburg, Alemania)

2. Lund Univ, Neurol Sect, Dept Clin Sci, (Lund, Suecia)

3. Charite Univ Med Berlin, Ctr Stroke Res Berlin (Berlin, Alemania)

4. Catalan Agcy Hlth Informat Assessment & Qual, Stroke Programme (Barcelona, España)

5. Umea Univ, Dept Publ Hlth & Clin Med (Umea, Suecia)

6. Western Gen Hosp, Dept Clin Neurosci, Edinburgh (Midlothian, Escocia)

7. Bavarian Permanent Working Party Qual Assurance (Munich, Alemania)

8. Kings Coll London, Div Hlth & Social Care Res (Londres, Inglaterra)

9. Universidad Leuven, Sch Med, Dept Neurol (Louvain, Bélgica)

10. Flemish Inst Biotechnol, Vesalius Res Ctr, (Louvain, Bélgica)

11. Ctr Guys & St Thomas NHS Fdn Trust, Natl Inst Hlth Res Biomed Res (Londres, Inglaterra)