Background Adherence to recommendations for osteoarthritis (OA) care can be measured using quality indicators (QI). In previous research differences related to the study design or the QI items make it challenging to directly compare the results. This EULAR funded study is the first that has applied the same set of QI items across four European countries.
Objectives To assess and compare patient perceived quality of OA management in primary health care in Denmark, Norway, Portugal, and the United Kingdom.
Methods Participants consulting general practitioners with clinical signs and symptoms of knee OA were identified in 30 general practices and invited to complete a cross-sectional survey including 14 QIs for OA care. A QI was considered as eligible if the participant had checked “Yes” or “No”, and as achieved if the participant had checked “Yes” to the indicator. The median percentage of eligible QIs achieved by country was determined and compared using negative binomial regression analyses. Achievement of individual QIs by country was determined and compared using logistic regression analyses.
Results A total of 354 participants self-reported QI achievement. For the total sample, the median percentage of QIs achieved (checked ‘Yes’) was 48% (IQR 28% to 64%; range 0-100%). By country, the median percentage of QIs achieved was relatively similar across three of the countries, but significantly lower in Denmark (23%) compared to Norway (50%) even after adjustment for age, gender, BMI and comorbidity (rate ratio 0.49; 0.39, 0.62). For individual QIs related to different aspects of OA care, significant differences in self-reported achievement rates between the four countries were seen (Table 1). Achievement rates on individual QIs showed a large variation ranging from 0% (“referral to services for losing weight” & “functional assessments” in Denmark) to 83% (“information about the importance of exercise” in Norway). Compared to Norway, the achievement rates were significantly lower for 10 QIs in Denmark, 2 QIs in Portugal and 1 QI in the UK, whereas UK had significantly higher achievement rates than Norway for 5 QIs.
Conclusions The results revealed a potential for improvement in OA care in all four countries, but for somewhat different aspects of OA care. By exploring these differences and comparing health care services across countries, ideas may be generated on how the quality of OA care might be improved. Larger studies are needed to confirm and further explore the findings in this study.
Disclosure of Interest None declared
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