Abstract
Nowadays, evaluating the quality of health services, especially in primary health care (PHC), is increasingly important. In a historical perspective, the Department of Health (United Kingdom) developed and proposed a range of indicators in 1998, and lately several health, social and political organizations have defined and implemented different sets of PHC quality indicators. Some systematic reviews in PHC quality indicators are reported but only in specific contexts and conditions. The aim of this study is to characterize and provide a list of indicators discussed in the literature to support managers and clinicians in decision-making processes, through an umbrella review on PHC quality indicators. The methodology was performed according to PRISMA Statement. Indicators from 33 eligible systematic reviews were categorized according to the dimensions of care, function, type of care, domains and condition contexts. Of a total of 727 indicators or groups of indicators, 74.5% (n = 542) were classified in process category and 89.5% (n = 537) with chronic type of care (n = 428; 58.8%) and effective domain (n = 423; 58.1%) with the most frequent values in categorizations by dimensions. The results of this overview of reviews are valuable and imply the need for future research and practice regarding primary health care quality indicators in the most varied conditions and contexts to generate new discussions about their use, comparison and implementation.
Highlights
The studies identified by that involved RAND methodology, their inclusion in the umbrella review was justified since the methods included an initial systematic review prior the implementation of a panel discussion for validating appropriateness of indicators
As the aim of this umbrella review of systematic reviews was to search indexed literature, in order to find a setlist of QI useful for monitoring quality in Primary health care (PHC), our study shows interesting answers to what was proposed, identifying 33 systematic reviews of studies on quality indicators in primary health care and providing a list of selected indicators considered in the included reviews
Most studies were missing information regarding the numerator, denominator and calculation method for each QI. This is, to the best of our knowledge, the first umbrella review focusing on QIs for primary healthcare in a border scope
Summary
The aim of this study is to characterize and provide a list of indicators discussed in the literature to support managers and clinicians in decisionmaking processes, through an umbrella review on PHC quality indicators
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