Abstract
ObjectiveTo develop key performance indicators that evaluate the effectiveness of a prescription medication system.MethodsA modified RAND/UCLA appropriateness method was used to develop key performance indicators (KPIs) for a prescription medication system. A broad list of potential KPIs was compiled. A multidisciplinary group composed of 21 experts rated the potential KPIs. A face-to-face meeting was held following the first rating exercise to discuss each potential KPI individually. The expert panel undertook a final rating of KPIs. The final set of KPIs were those indicators where at least 80 percent of experts rated the indicator highly i.e. rating of ≥ 7 on a scale from 1 to 9.Results292 KPIs were identified from the published literature. After removing duplicates and combining similar indicators 71 KPIs were included. The final ranking resulted in six indicators being ranked 7 or higher by 80% of the respondents and an additional seven indicators being ranked 7 or higher by ≥70 but ≤80% of respondents. The six selected indicators include four specific disease areas, measure structural and process aspects of health service delivery, and assessed three of the domains of healthcare quality: efficiency, effectiveness, and safety.ConclusionsThese indicators are recommended as a starting point to assess the current performance of prescription medication systems. Consideration should be given to developing indicators in additional disease areas as well as indicators that measure the domains of timeliness and patient–centeredness. Future work should focus on the feasibility of measuring these indicators.
Highlights
Effective prescription medication systems ensure patients can access needed medications, reduce overuse of inappropriate medications, and optimize use of cost-effective medications. [1,2] Prescription medication systems include, but extend beyond publicly funded drug plans
key performance indicators (KPIs) for prescription medication systems service delivery, and assessed three of the domains of healthcare quality: efficiency, effectiveness, and safety. These indicators are recommended as a starting point to assess the current performance of prescription medication systems
Consideration should be given to developing indicators in additional disease areas as well as indicators that measure the domains of timeliness and patient–centeredness
Summary
Effective prescription medication systems ensure patients can access needed medications, reduce overuse of inappropriate medications, and optimize use of cost-effective medications. [1,2] Prescription medication systems include, but extend beyond publicly funded drug plans. In a recent review of Canadian provincial drug plans many differences were noted in who was covered, what medications were covered, the total medication expenditures of each province, the government share of the total expenditure, and the out-of-pocket costs borne by the patient.[3] To inform decision making about the optimal organization of a prescription medication system it is important to have metrics to evaluate the effectiveness of a jurisdiction’s prescription medication system. The assessment of performance identifies gaps between current and desired outcomes and provides an indication of progress towards closing the gaps.[4] KPIs are commonly used to measure and improve upon the performance of healthcare systems; no KPIs have been developed to evaluate or compare prescription drug systems across jurisdictions. In England, KPIs have been used through the Quality and Outcomes Framework (QOF) to standardize and incentivize improvements in the delivery of primary medical care.[6,7] While some of the QOF indicators encourage appropriate medication use, the focus of QOF is on primary health care delivery
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