Background and Aims: Liver disease (LD) is a major cause of morbidity and mortality worldwide. Development of outcome indicators (OIs) provides health care policy makers with objective criteria that can be used to generate a virtuous competition to improve value of care. Aim of our study was to generate and test a set of health care OIs for the major LDs. Methods: Using a modified Delphi method, 7 expert panels identified a set of OIs according to experience and scientific evidence (as of 2010). Each OI was rated in a two-step process using the RAND 9-point agreement scale. Median scores were computed for each OI. After the second rating, a disagreement index (DI) was calculated to identify and accept (if DI≤1) OIs with median rating ≥7. The final set of selected OIs was tested through an ongoing prospective multicenter observational study involving three tertiary centers in Lombardy, Italy. Results: A total of 51 OIs were identified by the focus groups. We recruited 3213 consecutive liver patients, of whom 91% had at least one follow-up visit after a median follow-up time of 15 months. Among these patients, 1752 were cirrhotic and 711 were affected by HCC. During observation time, 156 patients were transplanted and 210 patients died. All the identified OIs were successfully tested in the clinical setting showing excellent performance and correlation with natural history information. Conclusions: This study provides a set of validated outcomes indicators that can be used to monitor the performance of referral centers and improve the value and sustainability of care.

Rota, M., Okolicsanyi, S., Ciaccio, A., Gemma, M., Gentiluomo, M., Grisolia, A., et al. (2014). Generation and performance of value-based outcome indicators in liver disease: The multicenter V.B.M.H. study. JOURNAL OF HEPATOLOGY, 60(1, Supplement), 517-517 [10.1016/S0168-8278(14)61440-9].

Generation and performance of value-based outcome indicators in liver disease: The multicenter V.B.M.H. study

ROTA, MATTEO;OKOLICSANYI, STEFANO;CIACCIO, ANTONIO;GEMMA, MARTA;GENTILUOMO, MARIA;CORTESI, PAOLO ANGELO;SCALONE, LUCIANA;MANTOVANI, LORENZO GIOVANNI;CESANA, GIANCARLO;VALSECCHI, MARIA GRAZIA;Colledan, M;Fagiuoli, S;STRAZZABOSCO, MARIO
2014-04

Abstract

Background and Aims: Liver disease (LD) is a major cause of morbidity and mortality worldwide. Development of outcome indicators (OIs) provides health care policy makers with objective criteria that can be used to generate a virtuous competition to improve value of care. Aim of our study was to generate and test a set of health care OIs for the major LDs. Methods: Using a modified Delphi method, 7 expert panels identified a set of OIs according to experience and scientific evidence (as of 2010). Each OI was rated in a two-step process using the RAND 9-point agreement scale. Median scores were computed for each OI. After the second rating, a disagreement index (DI) was calculated to identify and accept (if DI≤1) OIs with median rating ≥7. The final set of selected OIs was tested through an ongoing prospective multicenter observational study involving three tertiary centers in Lombardy, Italy. Results: A total of 51 OIs were identified by the focus groups. We recruited 3213 consecutive liver patients, of whom 91% had at least one follow-up visit after a median follow-up time of 15 months. Among these patients, 1752 were cirrhotic and 711 were affected by HCC. During observation time, 156 patients were transplanted and 210 patients died. All the identified OIs were successfully tested in the clinical setting showing excellent performance and correlation with natural history information. Conclusions: This study provides a set of validated outcomes indicators that can be used to monitor the performance of referral centers and improve the value and sustainability of care.
No
Abstract in rivista
Health care indicators; Liver diseases; Delphi method; Prospective study; Value based Medicine in Hepatology
English
Abstracts of The International Liver Congress™ 2014 – 49th Annual meeting of the European Association for the Study of the Liver-> Poster n° P1281 presented at the 49th annual meeting of the EASL (“European Association for the Study of the Liver”). London (United Kingdom), 09-13 April 2014
Rota, M., Okolicsanyi, S., Ciaccio, A., Gemma, M., Gentiluomo, M., Grisolia, A., et al. (2014). Generation and performance of value-based outcome indicators in liver disease: The multicenter V.B.M.H. study. JOURNAL OF HEPATOLOGY, 60(1, Supplement), 517-517 [10.1016/S0168-8278(14)61440-9].
Rota, M; Okolicsanyi, S; Ciaccio, A; Gemma, M; Gentiluomo, M; Grisolia, A; Cortesi, P; Scalone, L; Mantovani, L; Cesana, G; Valsecchi, M; Pontisso, P; Mondelli, M; Marchesini, G; Fabris, L; Mazzaferro, V; Burra, P; Colledan, M; Fagiuoli, S; Belli, L; Strazzabosco, M
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/51294
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