1st.IndiQare – Quality indicators in primary health care: validation and application of quality indicators as an evaluation and comparison tool
The project 1st.IndiQare – Quality indicators in primary health care: validation and application of quality indicators as an evaluation and comparison tool, began in July 2018 aiming to contribute to improving the quality and efficiency of primary health care (PHC).
To this end, the project will evaluate PHC in Portugal using quality indicators and secondary data, and taking into account expected epidemiological evolution of the population, current economic constraints and ongoing reforms related to organizational models.
Based on the work that will be developed, a web tool will be created for continuous monitoring of the national PHC system.
Primary health care (PHC) takes a pivotal role in healthcare systems. PHC services contribute for improving health outcomes and cost performance of health systems, reducing disparities in care and increasing population opportunities to lead healthy and productive lives. As a result, much emphasis has been put on PHC reforms during the last decade in Portugal. Despite noticeable improvements in quality of PHC, asymmetries across health services and across PHC units persist. Moreover, while continued debate regarding the organizational models of PHC units remains, a growing role and responsibility for the health of the Portuguese population is expected from the PHC system in Portugal, as aging population and burden of chronic diseases, associated with budgetary constraints, will increase health needs and pressure the PHC. Regular monitoring plays a critical role to assess quality of PHC, where health care indicators are essential to guide decision makers in the definition and assessment of health reforms, ultimately aiming at producing better outcomes at either population or cost-saving level. Therefore, considerable efforts have been made in several countries, including Portugal, in order to adopt and develop performance indicators in PHC. However, the abundance of indicators complicates assessment and comparisons processes. With this in mind, the overall goal of this project is to assess PHC in Portugal through quality indicators using secondary data, taking into consideration the expected evolution of the population epidemiology, current economic constraints and organizational reforms in place. Ultimately aiming at the improvement of quality in PHC and its management efficiency. This overarching goal will be breakdown into specific objectives, which aim at a) selecting a set of indicators that provide a reliable portrayal of the quality of PHC; b) verifying whether existing data is adequate in terms of coding practices and quality to calculate quality indicators; c) describing trends of primary care quality indicators in Portugal at local, regional and national level; d) identifying factors that have an impact on PHC quality metrics; and e) comparing the performance and efficiency between different organizational models in Portuguese PHC services.
The implementation of the proposed objectives is expected to render five main outputs namely four comprehensive reports: one containing enhanced information on existing PHC indicators, another providing assessment of quality of available data sources, and two other describing trends associated with selected quality indicators, offering an evaluation of the quality of the Portuguese PHC services and a comparison of the different organizational models with regard to quality and efficiency. Using the work developed, we will deliver a fifth outcome, which will consist of a validated web-based tool for continuous monitoring of the PHC system in Portugal.
CINTESIS researchers involved
Alberto Freitas (PI), Altamiro Costa-Pereira (Co-PI), Paulo Santos, Carlos Martins, João Vasco Santos, João Viana, António Pereira, Fernando Lopes, Manuel Gonçalves-Pinho, Luís Almeida Santos, Armando Teixeira-Pinto (University of Sydney, Australia)