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Objective. To develop evidence-based technology for creation or selection of quality indices of health care in hypertensive patients aiming at clinical result — achievement of the goal blood pressure (BP). Design and methods. To identify the major causes of non-achievement of the goal BP we used the method of systems analysis of clinical incidents — fishbone diagram. To construct the diagram system review of literature (E-library, PubMed) including the results of own previous investigations was performed. Results. The following major causes of target BP nonachievement were identified: doctor-related — inadequate therapy, patient-related — low adherence, healthcare system-related — low medical care availability. The following indices were proposed to control the mentioned issues: «BP measurement», «Two antihypertensive drugs administration», «Target BP recorded», «Target BP not recorded and two antihypertensive drugs not administered». Principal stages of performance measures creation were proposed. Conclusions. Clear definition of clinical therapeutic result together with the system analysis methods allow the development of the evidence-based measures healthcare quality assessment.
Posnenkova OM, Kiselev AR, Gridnev VI, Popova YuV, Volkova EN, Dovgalevskiy PYa. Aiming at clinical result - the basis of modern technology of quality measures development for hypertensive patients. Arterial Hypertension 2014; 20(3): 212-217. Russian