• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Session 3: Ahmed Aboulghate
 

Session 3: Ahmed Aboulghate

on

  • 284 views

Ahmed Aboulghate: “Developing quality indicators for the Egyptian Primary Care system”

Ahmed Aboulghate: “Developing quality indicators for the Egyptian Primary Care system”

Statistics

Views

Total Views
284
Views on SlideShare
284
Embed Views
0

Actions

Likes
0
Downloads
0
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Session 3: Ahmed Aboulghate Session 3: Ahmed Aboulghate Presentation Transcript

    • Ahmed Aboulghate , MBBCh, MPhil University of Cambridge PhD student, Cambridge Overseas Scholar Developing Quality Indicators for the Egyptian Primary Care System
    •  
    • Egypt; background
      • Population 73 million
      • Lower-middle income country (Poverty level 16.7%)
      • Dual burden of disea se.
      National Burden of Disease NCD 74% Communicable 9% Injuries 7% Others 10% Leading contributors to National Burden of Disease Ischaemic Heart Disease 11 % Unipolar Depression 5 % Asthma, COPD 4 % Cerebrovascular Disease 4 % Respiratory Infections 3 % Cataract 3 % Adult Onset Hearing Loss 3 % Hypertensive Heart Disease 3 % Drug Use Disorders 2 % Liver Cirrhosis 2 %
    • Egyptian Health Care System
      • Social insurance
            • Free for eligible patients (48% of population)
            • Employees, infants, school children, pensioners, widows
      • State run facilities
            • Everyone is eligible
            • Limited resources, low quality
      • Private sector
            • Out of pocket (60% of national health expenditure)
            • Serves all population categories
            • Varying quality and price
    • 1997: Health Sector Reform Project
      • Universal coverage
      • High quality
      • Equity
      • Efficiency
      • Sustainability
            • To shift the focus of care from heavy reliance on inpatient care to a more integrated and less costly primary care model. (Berman et al, 1998).
    • Reforming the Primary Care
      • Infra structure:
            • Renovating and building PC facilities
            • Today: 5500 PC facilities
      • Care providers
            • Financial and career incentives
      • Quality control
            • Accreditation
            • Pay for performance through Quality Indicators
    • Current Indicators in the Egyptian Primary Care
      • Limitations of the current indicators
        • Emphasis on ‘structure’ indicators
        • ‘ Process’ indicators are vague and broadly defined
        • Scores are manually collected through inspection visits
      Type Number of indicators included Total 34 Structure 25 Process 6 Outcome 3
    • Aims of the study
      • NOT TO : Copy and Paste indicators (e.g. QOF)
      • BUT TO : Transfer technologies and methods
      • Methodology
      • Choose the medical conditions
      • Develop indicators for them
      • Pilot the new indicators
    • 1. Choosing the conditions
      • The most common conditions presenting to primary care units
            • Primary data collection
            • >2000 patients
            • 12 primary care units
      • National Burden of Disease
      • Basic Benefit Package
    • 2. Developing the indicators
      • The RAND/UCLA appropriateness method
            • Literature and guidelines review
            • Developing preliminary set of indicators
            • Rating the indicators by a group of local experts
            • Panel meeting to discuss and re-rate the indicators
      Indicator Quality of evidence References Benefits/ summary Necessity Validity Patients with CAD should be advised to take aspirin at a dose of 75-100 mg/day unless contraindicated I Yusuf et al, 1998 ATC, 1994 Absolute reduction in vascular events of 5% (1-9) (1-9)
    • 3. Piloting the indicators
      • Extracting Indicators scores from patients records
      • Testing the time and resources required to extract the indicators
      • Testing the inter-rater reliability
    • Opportunities
      • Measure the feasibility of applying the new indicators
      • Propose modifications to the electronic recording system to implement automated indicator score calculation
      • Building a culture of Evidence Informed policy making
    • Thank you