RT Journal Article
SR Electronic
T1 A practice test and selection of a core set of outcome-based quality indicators in Dutch primary care physical therapy for patients with COPD: a cohort study
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00008-2022
DO 10.1183/23120541.00008-2022
A1 Arie C. Verburg
A1 Simone A. van Dulmen
A1 Henri Kiers
A1 Maria W. G. Nijhuis-van der Sanden
A1 Philip J. van der Wees
YR 2022
UL http://openres.ersjournals.com/content/early/2022/06/09/23120541.00008-2022.abstract
AB Aim To estimate the comparability and discriminability of outcome-based quality indicators by performing a practice test in Dutch physical therapy primary care, and to select a core set of outcome-based quality indicators that are well-accepted by physical therapists based on their perceived added value as a quality improvement tool.Methods First, a list of potential quality indicators was defined, followed by the determination of the comparability (case-mix adjusted multi-level analysis) and discriminability (intraclass correlation coefficient (ICC)). Second, focus group meetings were conducted with stakeholders (physical therapists and senior researchers) to select a core set of quality indicators.Results Overall, 229 physical therapists from 137 practices provided 2651 treatment episodes. Comparability: in 10 of the 11 case-mix adjusted models, the ICC increased compared with the intercept-only model. Discriminability: the ICC ranged between 0.01 and 0.34, with five of the 11 ICCs being >0.10. The majority of physical therapists in each focus group preferred the inclusion of seven quality indicators in the core set, including three process and four outcome indicators based upon the Six-Minute-Walk-Test (6MWT), the Clinical COPD Questionnaire (CCQ), and the determination of quadriceps strength using a hand-held dynamometer (HHD).Conclusion This is the first study that describes the comparability and discriminability of the outcome-based quality indicators selected for patients with COPD treated in primary care physical therapy practices. Future research should focus on increasing data collection in daily practice and on the development of tangible methods to use as the core set of a quality improvement tool.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Arie C. Verburg has nothing to disclose.Conflict of interest: Simone A. van Dulmen has nothing to disclose.Conflict of interest: Henri Kiers has nothing to disclose.Conflict of interest: Maria W. G. Nijhuis-van der Sanden has nothing to disclose.Conflict of interest: Philip J. van der Wees has nothing to disclose.