Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/30425
Title: Association of clinic setting with quality indicator performance in systemic lupus erythematosus: a cross-sectional study.
Austin Authors: Sreedharan, Sidha;Li, Ning;Littlejohn, Geoff;Buchanan, Russell R C ;Nikpour, Mandana;Morand, Eric;Golder, Vera;Hoi, Alberta Y 
Affiliation: The University of Melbourne at St Vincent's Hospital Melbourne, Melbourne, Australia
Monash University, Melbourne, Australia
Monash Health, Melbourne, Australia
Austin Health
Monash University, Melbourne, Australia. sidha.sreedharan@monash.edu.. Monash Health, Melbourne, Australia. sidha.sreedharan@monash.edu..
Issue Date: 22-Jun-2022
Date: 2022
Publication information: Arthritis research & therapy 2022-06-22; 24(1): 150
Abstract: Healthcare quality for systemic lupus erythematosus (SLE) is a modifiable target for improving patient outcomes. We aimed to assess the quality of care processes in different clinic settings, comparing a subspecialty lupus clinic with hospital-based and private general rheumatology clinics. Patients with SLE (n = 258) were recruited in 2016 from a subspecialty lupus clinic (n = 147), two hospital general rheumatology clinics (n = 56) and two private rheumatology clinics (n = 55). Data were collected from medical records and patient questionnaires. Quality of care was assessed using 31 validated SLE quality indicators (QI) encompassing diagnostic work-up, disease and comorbidity assessments, drug monitoring, preventative care and reproductive health. Per-QI performance was measured as a percentage of patients that met the QI relative to the number of patients eligible. Per-patient QI performance was calculated as a percentage of QIs met relative to the number of eligible QIs for each patient. Per-QI and per-patient QI performance were compared between the three clinic settings, and multiple regression performed to adjust for sociodemographic, disease and healthcare factors. Per-QI performance was generally high across all clinic settings for diagnostic work-up, comorbidity assessment, lupus nephritis, drug monitoring, prednisolone taper, osteoporosis and pregnancy care. Median [IQR] per-patient performance on eligible QIs was higher in the subspeciality lupus clinic (66.7% [57.1-74.1]) than the hospital general rheumatology (52.7% [47.5-58.1]) and private rheumatology (50.0% [42.9-60.9]) clinics (p <0.001) and the difference remained significant after multivariable adjustment. The subspecialty lupus clinic recorded higher per-QI performance for documentation of disease activity, disease damage, cardiovascular risk factor and drug toxicity assessments, pre-immunosuppression hepatitis and tuberculosis screening, new medication counselling, vaccinations, sun avoidance education and contraception counselling. SLE patients managed in a subspecialty lupus clinic recorded higher per-patient QI performance compared to hospital general rheumatology and private rheumatology clinics, in part related to better documentation on certain QIs.
URI: https://ahro.austin.org.au/austinjspui/handle/1/30425
DOI: 10.1186/s13075-022-02823-9
Journal: Arthritis research & therapy
PubMed URL: 35733186
Type: Journal Article
Subjects: Quality indicators
Quality of care
Systemic lupus erythematosus
Appears in Collections:Journal articles

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