Towards a harmonised framework for developing quality of care indicators for global health: a scoping review of existing conceptual and methodological practices

Abstract

ObjectivesDespite significant advances in the science of quality of care measurement over the last decade, approaches to developing quality of care indicators for global health priorities are not clearly defined. We conducted a scoping review of concepts and methods used to develop quality of healthcare indicators to better inform ongoing efforts towards a more harmonised approach to quality of care indicator development in global health.MethodsWe conducted a systematic search of electronic databases, grey literature and references for articles on developing quality of care indicators for routine monitoring in all healthcare settings and populations, published in English between 2010 and 2020. We used well-established methods for article screening and selection, data extraction and management. Results were summarised using a descriptive analysis and a narrative synthesis.ResultsThe 221 selected articles were largely from high-income settings (89%), particularly the USA (46%), Canada (9%), UK (9%) and Europe (17%). Quality of care indicators were developed mainly for healthcare providers (56%), for benchmarking or quality assurance (37%) and quality improvement (29%), in hospitals (32%) and primary care (26%), across many diseases. The terms ‘quality indicator’ and ‘quality measure’ were the most frequently encountered terms (50% and 21%, respectively). Systematic approaches for quality of care indicator development emerged within national quality of care systems or through cross-country collaborations in high-income settings. Maternal, neonatal and child health (33%), mental health (26%) and primary care (57%) studies applied most components of systematic approaches, but not consistently or rigorously.DiscussionThe current evidence shows variations in concepts and approaches to developing quality of care indicators, with development and application mainly in high-income countries.ConclusionAdditional efforts are needed to propose ‘best-practice’ conceptual frameworks and methods for developing quality of care indicators to improve their utility in global health measurement.

Health Information System and Health Care Applications Performance in the Healthcare Arena: A Bibliometric Analysis

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“…To provide health care interventions with the attention they deserve, a sustainable and resilient HIS is required as well as a well-defined health priority globally [ 18 , 46 ]. The transformation and performance of HIS and health care applications in the healthcare arena are considered to be favourable over the decades, despite the uncertainty within the global space [ 47 ].…”

Identifying potential predictable indicators for the management of tertiary hospitals

“…Although outcome measures are of greater interest and can reflect all aspects of care, 17 our findings show care process indicators are more readily measured, which would favour the Feasibility of predicting them. As Mainz J. and other authors points out in their works, they would be more sensitive to differences in the quality of care 18–20 . On the other hand, managers prioritised two infrastructure and resources indicators.…”

“…As Mainz J. and other authors points out in their works, they would be more sensitive to differences in the quality of care. [18][19][20] On the other hand, managers prioritised two infrastructure and resources indicators. These structure measures, which are traditionally assessed to ascertain whether care is provided under conditions that are either conducive or inimical, 18 might be predictive of resource allocation in the foreseeable future.…”

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