Developing quality indicators for general practice care for vulnerable elders; transfer from US to The Netherlands

Area of Science:

• Healthcare Quality Improvement
• Geriatric Care
• Cross-Cultural Adaptation of Indicators

Background:

• Measuring healthcare quality is crucial for improvement.
• Systematically developed quality indicators are essential for quality measurement.
• Adaptation of US quality indicators for vulnerable elders in the Netherlands was explored.

Purpose of the Study:

• To adapt US quality indicators for vulnerable elders in the Netherlands.
• To compare US and Dutch quality indicator sets.
• To assess the transferability of healthcare quality indicators between countries.

Main Methods:

• A panel of nine Dutch clinical experts assessed 108 US quality indicators for GP care in vulnerable elders.
• A modified RAND/UCLA appropriateness method was employed.
• Evidence reviews, including Dutch literature, were provided to the expert panel.

Main Results:

• 72% of the US quality indicators were identical or nearly identical in the Dutch set.
• Indicator transferability varied by condition; only 50% for undernutrition and 29% for depression were retained.
• Significant differences were observed, particularly for undernutrition and depression.

Conclusions:

• Quality indicators are transferable but require careful adaptation.
• Differences in expert opinion and considered evidence impact indicator transferability.
• Country-specific adaptation is necessary, especially when evidence bases or expert priorities diverge.