Quality and performance indicators in healthcare networks: Implementation of feedback reports in the integrated care system Gesundes Kinzigtal in Germany

Abstract

Purpose: Indicators for measuring quality or economic performance are already used in different contexts in health care systems (e.g. Quality and Outcome Framework, HEDIS, hospital quality reports). Basic insights from these initiatives can and should be used for further development. Experiences with systematically developed indicators for outpatient as well as cross-sectoral care, which are implemented in real life integrated care systems (ICS), are still rare. Purpose of this presentation is to give insights to the development and implementation process of indicators in the ICS Gesundes Kinzigtal. Methods: Different sources for indicators in health care were reviewed in context of the ICS Gesundes Kinzigtal considering the ICS strategy as well as data availability and practicability. A set of indicators was created that is constantly evolving and giving relevant information in the form of electronic reports to care providers, the net management, the project management team and other stakeholders of the ICS. The data used for the reports is claims data from health insurance companies, data from the physicians’ practice management software, claims data as well as primary data from the local management company and other primary data e.g. collected from patient surveys. Results: Up to now the most advanced feedback reports in the ICS Gesundes Kinzigtal are those for general practitioners and for the net management. These reports have been developed under strong involvement of all relevant stakeholders. The net management report currently includes about thirty indicators providing information about different parts of care, presented in a framework referring to the Donabedian Model with the three categories of “structure”, “process” and “outcomes”. The software used to view the reports allows an overview with high information density but also provides detailed analysis for each indicator. One exemplary report with detailed information for some chosen indicators will be shown. Conclusions: It is of outstanding importance that the set of indicators is developed in cooperation with the different kinds of recipients that are supposed to use the reports to compare and improve regional health care. Critical suggestions must be part of the ongoing development process. Furthermore it is crucial that information is provided in a clear and easy way. In the ICS Gesundes 14th International Conference on Integrated Care, Brussels, April 2-4 2014 International Journal of Integrated Care – Volume 14, 01 October – URN:NBN:NL:UI:10-1-116136– http://www.ijic.org/ Kinzigtal feedback reports are in a steady development process but initial successes of the regional health care optimization can be detected in the development of several indicators over time.