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Can health care quality indicators be transferred between countries?
M N Marshall1, P G Shekelle, E A McGlynn
1National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL, UK. martin.marshall@man.ac.uk
Quality & Safety in Health Care
|February 7, 2003
Summary
Primary care quality indicators developed in the USA were adapted for the UK, with over half showing equivalence. Direct transfer is limited by differences in clinical practice and professional norms between countries.
Area of Science:
- Health Services Research
- Quality Improvement
- Comparative Health Systems
Background:
- Developing robust quality indicators is crucial for healthcare improvement.
- International collaboration can leverage existing quality measurement tools.
- Understanding cross-national applicability of quality indicators is essential.
Purpose of the Study:
- To assess the transferability of primary care quality indicators between the United Kingdom (UK) and the United States (USA).
- To compare quality indicators for common clinical problems developed using a consistent methodology in both countries.
Main Methods:
- Quality indicators initially developed in the USA using the RAND-UCLA appropriateness method were applied to 19 primary care conditions in the UK.
- Literature reviews were updated, and UK primary care practitioners convened to adapt indicators for the British context.
Main Results:
- Of 174 US indicators for 18 conditions, 98 (56.3%) had equivalent or nearly equivalent indicators in the UK set.
- Differences were attributed to indicator development processes and variations in clinical practice or professional norms.
- No significant relationship was found between the strength of evidence and indicator transferability.
Conclusions:
- Leveraging work from other countries offers significant benefits in developing quality of care measures.
- Direct transfer of quality indicators between countries is not feasible without adaptation for variations in professional culture and clinical practice.
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