[Epidemiological standards for assessing quality: a proposal]

Area of Science:

• Healthcare Quality Assessment
• Maternal and Child Health
• Public Health Indicators

Background:

• Assessing healthcare quality is crucial for improving patient outcomes and resource allocation.
• Existing methods may not fully capture the nuances of comprehensive care, especially in perinatal services.
• A systematic approach is needed to evaluate the adherence to clinical guidelines and achieve care objectives.

Purpose of the Study:

• To propose and apply a strategy for defining indicators to assess healthcare process quality.
• To evaluate the quality of perinatal care in 12 hospitals using a comprehensive, risk-based approach.
• To identify specific quality indicators for childbirth care and classify hospital performance.

Main Methods:

• Developed a methodology based on identifying care objectives and verifying adherence to technical guidelines.
• Applied the methodology to perinatal clinical histories (CLAP/PAHO/WHO) from 4,558 cases across 12 hospitals.
• Selected indicators including V.D.R.L., Rh typing, vaccinations, cesarean rates, neonatal assessment, Apgar scores, gestational age evaluation, rooming-in, breastfeeding, and postpartum consultation referrals.

Main Results:

• Classified hospitals based on indicator scores, identifying one with excellent quality, five with good, two with fair, and four with unsatisfactory performance.
• Demonstrated the utility of the proposed indicator-based strategy in differentiating hospital quality.
• Highlighted specific areas of care, such as neonatal reception and breastfeeding, as key quality markers.

Conclusions:

• The proposed indicator-based strategy effectively assesses healthcare quality in childbirth processes.
• The methodology provides a quantifiable method for hospital performance evaluation and quality improvement initiatives.
• Further research should explore refining indicators and expanding the application to other healthcare domains.