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Review
Quality indicators for knee and hip osteoarthritis care: a systematic review
  1. Ilgin G Arslan1,
  2. Rianne M Rozendaal1,
  3. Marienke van Middelkoop1,
  4. Saskia A G Stitzinger2,
  5. Maarten-Paul Van de Kerkhove2,3,
  6. Vincent M I Voorbrood1,2,
  7. Patrick J E Bindels1,
  8. Sita M A Bierma-Zeinstra1,4 and
  9. Dieuwke Schiphof1
  1. 1General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
  2. 2General Practice Pallion, Hulst, The Netherlands
  3. 3Orthopaedics ZorgSaam Zeeuws-Vlaanderen, Terneuzen, The Netherlands
  4. 4Department of Orthopaedics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
  1. Correspondence to Ilgin G Arslan; i.arslan{at}erasmusmc.nl

Abstract

To provide an overview of quality indicators (QIs) for knee and hip osteoarthritis (KHOA) care and to highlight differences in healthcare settings. A database search was conducted in MEDLINE (PubMed), EMBASE, CINAHL, Web of Science, Cochrane CENTRAL and Google Scholar, OpenGrey and Prospective Trial Register, up to March 2020. Studies developing or adapting existing QI(s) for patients with osteoarthritis were eligible for inclusion. Included studies were categorised into healthcare settings. QIs from included studies were categorised into structure, process and outcome of care. Within these categories, QIs were grouped into themes (eg, physical therapy). A narrative synthesis was used to describe differences and similarities between healthcare settings. We included 20 studies with a total of 196 QIs mostly related to the process of care in different healthcare settings. Few studies included patients’ perspectives. Rigorous methods for evidence synthesis to develop QIs were rarely used. Narrative analysis showed differences in QIs between healthcare settings with regard to exercise therapy, weight counselling, referral to laboratory tests and ‘do not do’ QIs. Differences within the same healthcare setting were identified on radiographic assessment. The heterogeneity in QIs emphasise the necessity to carefully select QIs for KHOA depending on the healthcare setting. This review provides an overview of QIs outlined to their healthcare settings to support healthcare providers and policy makers in selecting the contextually appropriate QIs to validly monitor the quality of KHOA care. We strongly recommend to review QIs against the most recent guidelines before implementing them into practice.

  • quality indicators
  • knee osteoarthritis
  • osteoarthritis
  • health care
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Footnotes

  • Contributors All authors developed the first idea for the review. IGA, RMR and DS carried out the data collection and analysis. All authors gave their comments on the first and final version of this manuscript.

  • Funding This work was partly supported by the Dutch health insurance company CZ.

  • Disclaimer The funders had no role in the study design, data collection, data analysis, nor in the interpretation and reporting of results.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.