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[Agreement and differences between reviewers in a peer review procedure]
B Maier-Riehle1, N Gerdes, W Protz
1Department für Epidemiologie und Sozialmedizin, Bad Säckingen.
Gesundheitswesen (Bundesverband Der Arzte Des Offentlichen Gesundheitsdienstes (Germany))
|July 24, 1998
Summary
A new peer review process for rehabilitation care quality assurance in Germany demonstrated sufficient to good reliability. This method offers higher objectivity compared to previous American studies on hospital chart reviews.
Area of Science:
- Healthcare Quality Assurance
- Rehabilitation Medicine
- Medical Peer Review
Background:
- German statutory pension insurance institutions initiated a quality assurance program.
- The study addresses the need for reliable screening of rehabilitation care process quality.
Purpose of the Study:
- To evaluate the reliability and potential bias of a newly developed peer review procedure for rehabilitation care.
- To examine interrater reliability, intrarater reliability, and reviewer bias in a pilot study.
Main Methods:
- Experienced physicians were trained to review discharge reports from rehabilitation doctors.
- Peers assessed 56 process criteria across six categories, including case history.
- Reliability coefficients were calculated for category and overall quality judgments.
Main Results:
- Interrater reliability coefficients ranged from sufficient to good.
- Average intrarater reliability coefficients were also found to be sufficient to good.
- A small number of reviewers exhibited consistent leniency or harshness in ratings.
Conclusions:
- The developed peer review procedure demonstrates acceptable to good reliability for assessing rehabilitation care quality.
- The procedure appears to offer higher objectivity than peer review methods used in American studies of hospital charts.
- This tool can contribute to enhancing the quality assurance of rehabilitation services.