Table 1 Results of the first workshop: rated inappropriate for use as a QI in the Swiss healthcare setting
Category | Potential indicator | Reason |
|---|---|---|
General aspects, efficiency | Proportion of patients enrolled in health plans per region | Not related to quality of primary care |
General aspects, efficiency | Proportion of hospitalisations for interventions that can be adequately done in the ambulatory setting | Measures quality of hospital care/ hospital processes |
General aspects, efficiency | Number of hospitalisations per 1000 persons | Rather a measure of hospital processes, and density parameters than of primary care |
General aspects, efficiency | Proportion of patients receiving medication therapy | No clear indicator of quality. Not specific to primary care. |
General aspects, efficiency | Share of prescriptions of new me-too medications of the total market | A current classification of me-too medications is not available for Switzerland |
Respiratory disease | Proportion of patients with asthma or COPD receiving combinations of reproterol & cromoglicinic acid | reproterol and cromoglicinic acid are not on the Swiss market/ use is very unusual |
Respiratory disease | Proportion of patients with asthma or COPD receiving, die N-acetylcystein, ambroxol or myrtol for elimination of secret | Medications are not on the Swiss market/ use is very unusual |
Respiratory disease | Proportion of patients with COPD receiving pneumococcal vaccination | Asthma and COPD cannot be differentiated in the claims dataset because ambulatory diagnoses are lacking |
Respiratory disease | Proportion of pregnant women with incident therapy with leukotriene receptor antagonists | Relatively small number of cases, therefore not suitable for large scale measurement |
Respiratory disease | Proportion of pregnant women with incident specific immunotherapy | Relatively small number of cases, therefore not suitable for large scale measurement |
Respiratory disease | Proportion of children/ teenagers with asthma receiving oral beta-2-sympathomimetics in acute situations | Clinial information is missing |
Respiratory disease | Proportion of patients with asthma receiving inhalative medication | Identification of patients is based on medication. Therefore, no meaningful interpretation of results possible. |
Respiratory disease | Proportion of patients with asthma with long term inhalative corticosteroids | Asthma and COPD cannot be distinguished using claims data. Identification of patients is based on medication. Therefore, no meaningful interpretation of results possible. |
Cardiovascular disease | Proportion of patients with heart failure receiving laboratory control of electrolytes and renal function semi-yearly | Population cannot be determined because ambulatory diagnoses are lacking in Swiss health insurance claims |
Cardiovascular disease | Proportion of patients after coronary stent implant receiving triple therapy (ASS + Clopidogrel + Anticoagulation) | Measures quality of care of cardiologists/ interventional cardiologists (as opposed to primary care) |
Cardiovascular disease | Proportion of patients after aortocoronary Bypass / acute coronary syndrome and Anticoagulation only | Measures quality of care of cardiologists/ interventional cardiologists (as opposed to primary care) Measures quality of hospital care |
Cardiovascular disease | Proportion of patients after coronary bypass receiving multidisciplinary rehabilitation | No coherent way of accounting of rehabilitation services in Switzerland, no information about multidisciplinarity |
Cardiovascular disease | Proportion of ambulatory patients with laboratory test for BNP und NT-proBNP | Recommendation is not clear enough. |
Depression | Proportion of patients resistant to depression treatment receiving augmentation of antidepressants with carbamazepine, lamotrigine, pindolol, valproate, dopamine agonists, psychostimulants, thyroid hormone or other hormones | Clinical information is missing |
Diabetes mellitus | Proportion of patients with pain in diabetic neuropathy treated with traditional nonsteroidal antiphlogistics | Clinical information is missing |
Diabetes mellitus | Proportion of patients with pain in diabetic neuropathy treated with selective Cox-2 inhibitors | Clinical information is missing |