708 posters, 8 topics, 16 sessions, 1,190 authors, 600 institutions
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ISQua's 39th International Conference 2023
August 27 - 30, 2023 | Seoul, Republic of Korea
ISQUA2023-ABS-3169
DISENTANGLING VARIATION IN QUALITY OF CARE: A SYSTEMATIC REVIEW
Poster Presenter
Part of Topic
Patient Safety & Quality Improvement
To which extent do hospitals contribute to variation in quality of care?
Background
•Much effort is put into mitigating unwarrented variation in quality of care
•Understanding the degree of variation in quality of care at hospital level relative to total (or other levels) is crucial for successful quality improvement
•This share can be estimated using the variance partitioning coefficient (VPC), also known as intraclass correlation coefficient (ICC)
•Most recent literature overview: Fung et al. (2010)
Aim
To systematically review the results of quantitative studies that decomposed variation in quality indicators of hospital care, breaking down the results into specific estimates for each level of care
Methods
•Searched five databases: Medline, Embase, Web of Science, Cochrane, Google Scholar
•English, peer-reviewed articles that estimated relative share of hospital level variation in quality of care relative to total variation were included
•Categorization by type of indicator
Conclusion
•Degree of hospital and physician level variation is generally small compared to residual variation, however substantial variation may exist depending on indicator
•The latter especially for process indicators, which can be directly influenced
•Both absolute and relative variation are crucial to consider prior to designing and implementing quality improvement strategies