Perceived quality of health care services among people with osteoarthritis – results from a nationwide survey

Abstract

ObjectiveTo assess the perceived quality of care received by people with osteoarthritis (OA) in Norway and explore factors associated with the quality of care.MethodsA national survey in which members of the Norwegian Rheumatism Association with OA registered as their main diagnosis completed a questionnaire. The perceived quality of care was reported on a 17-item OsteoArthritis Quality Indicator questionnaire, covering both pharmacological and non-pharmacological aspects of OA care. In addition, the four-page questionnaire covered areas related to demographic characteristics, the location and impact of the OA, and utilization and satisfaction with health care services. The quality of care is calculated as pass rates, where the numerator represents the number of indicators passed and the denominator represents the number of eligible persons.ResultsIn total, 1,247 participants (response rate 57%) completed the questionnaire. Mean age was 68 years (standard deviation 32) and 1,142 (92%) were women. Respondents reported OA in hand only (12.4%), hip only (7.3%), knee only (10.4%), in two locations (42%) or all three locations (27%). The overall OsteoArthritis Quality Indicator pass rate was 47% (95% confidence interval [CI] 46%–48%), and it was higher for pharmacological aspects (53% [51%–54%]) than for non-pharmacological aspects of care (44% [43%–46%]). The pass rate for the individual quality indicators ranged from 8% for “referral for weight reduction” to 81% for “receiving advice about exercises”. Satisfaction with care was strongly associated with perceived quality. The pass rate for those who were “very satisfied” was 33% (25%–40%) higher than those who were “very unsatisfied” with care.ConclusionWhile the OA patient seems to be rather satisfied with the perceived OA care, there is still room for improvement in the quality of care. Although the quality of care in the present study is somewhat higher than in other studies, less than 50% of the recommended care has been provided.

Measurement properties for the revised patient-reported OsteoArthritis Quality Indicator questionnaire

“…Compared to a previous study in people with only knee OA including subsamples from Denmark, UK and Portugal, the mean total pass rate in the current study was higher than the Danish, but lower than the Portuguese and UK median pass rates 11 . The proportion of females in the current study was somewhat higher compared to three previous Norwegian studies 4,9,10 . The female predominance may be a result of a combination of the higher OA prevalence among females 1 and of females being more willing to participate in patient education programmes, which is also shown in previous research 24 .…”

Self-reported quality care for knee osteoarthritis: comparisons across Denmark, Norway, Portugal and the UK

“…In contrast to two previous studies, which showed that age, gender, education and severity of the OA disease were related to QI achievement, 13 14 patient characteristics in the present study were not associated with QI achievement. The median percentage of QIs achieved for the total study sample was similar to the rates in two previous studies of patient-reported OA QI achievement rates in primary healthcare, 24 27 34 higher median than in three studies 14 20 28 and lower median than in one study. 26 It has previously been shown that adherence to QIs in OA care was lower compared to that in gout or other chronic conditions in older adults.…”

Barriers for guideline adherence in knee osteoarthritis care: A qualitative study from the patients' perspective

“…Notwithstanding the publication of guidelines, there still appears to be a large gap between best practice as defined by scientific evidence and actual clinical care in knee OA as shown from several studies in different countries . A recent Norwegian study showed that guideline adherence to nonpharmacological treatment modalities was only 44% . Adherence to guidelines can be assessed with quality indicators, which are measurable elements in the diagnostic and therapeutic process and based on scientific evidence or consensus .…”

“…[10][11][12] A recent Norwegian study showed that guideline adherence to nonpharmacological treatment modalities was only 44%. 13 Adherence to guidelines can be assessed with quality indicators, which are measurable elements in the diagnostic and therapeutic process and based on scientific evidence or consensus. 14,15 A set of 21 quality indicators for the management of OA was developed for the Belgian primary health care system.…”