RESUMO
BACKGROUND: The management of lymphoedema is complex and should be based on guidelines. To date, no data assessing quality of care in lymphoedema in Germany are available. OBJECTIVE: We aimed at evaluating the quality of care of lymphoedema in the metropolitan area of Hamburg using guideline-based indicators. METHODS: Cross-sectional, community-based study including patients with lymphoedema. Assessment included a structured interview, clinical examination and patient-reported outcomes. Quality indicators derived from guidelines by a Delphi consensus were applied. RESULTS: 348 patients (median age 60.5 years) with lymphoedema (66.4%), lipoedema (9.5%) or combined oedema (24.1%) were included. 86.4% performed compression therapy, 85.6% received lymphatic drainage. On average 55.0% of the quality of care criteria were met; 64.8% were satisfied with care. The distribution curve of the health care index was almost normal. Treatment by specialists led to a higher quality of care index. CONCLUSION: Although overall quality of care in lymphoedema is fair, many patients are not treated properly according to guidelines.
Assuntos
Redes Comunitárias/normas , Linfedema/terapia , Indicadores de Qualidade em Assistência à Saúde , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Estudos Transversais , Técnica Delphi , Dermatologia , Drenagem , Feminino , Medicina Geral , Alemanha , Fidelidade a Diretrizes , Ginecologia , Humanos , Medicina Interna , Linfedema/diagnóstico , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Guias de Prática Clínica como Assunto , Meias de Compressão , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Treatment of lymphoedema is complex and needs specific skills. There are no standards for the evaluation of quality of care. OBJECTIVE: Development and application of indicators for the measurement of quality of care in lymphoedema. METHODS: In a three-step process including a national Delphi expert consensus, quality indicators were derived from national and international guidelines. In a cross-sectional study involving a large spectrum of care providers, the quality of lymphoedema care in the community was assessed by transforming the indicators to one unweighted quality index (QI). RESULTS: A total of 12 quality indicators were identified and applied to n = 348 patients with lymphoedema and lipolymphoedema of any origin in the metropolitan area of Hamburg (90.8% female, mean age 57, SD 14.5 years). On average, 55% of the quality indicators were met, and 64.8% of the patients were satisfied with lymphoedema care. There was a significant correlation between QI and satisfaction. CONCLUSIONS: The quality indicators and the QI are feasible and valid for the evaluation of quality of care. They can support optimizing lymphoedema care.