Definition of a core set of quality indicators for the assessment of HIV/AIDS clinical care: a systematic review
1 Department of Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
2 Department of Pathology, Faculty of Medicine, Universidade Agostinho Neto, Luanda, Angola
3 CINTESIS - Center for Research in Health Technologies and Information Systems, University of Porto, Porto, Portugal
4 National School of Public Health, University Nova de Lisboa, Lisbon, Portugal
5 Department of Infectious Diseases, Faculty of Medicine, University of Porto, Porto, Portugal
BMC Health Services Research 2013, 13:236 doi:10.1186/1472-6963-13-236Published: 28 June 2013
Several organizations and individual authors have been proposing quality indicators for the assessment of clinical care in HIV/AIDS patients. Nevertheless, the definition of a consensual core set of indicators remains controversial and its practical use is largely limited. This study aims not only to identify and characterize these indicators through a systematic literature review but also to propose a parsimonious model based on those most used.
MEDLINE, SCOPUS, Cochrane databases and ISI Web of Knowledge, as well as official websites of organizations dealing with HIV/AIDS care, were searched for articles and information proposing HIV/AIDS clinical care quality indicators. The ones that are on patient’s perspective and based on services set were excluded. Data extraction, using a predefined data sheet based on Cochrane recommendations, was done by one of the authors while a second author rechecked the extracted data for any inconsistency.
A total of 360 articles were identified in our search query but only 12 of them met the inclusion criteria. We also identified one relevant site. Overall, we identified 65 quality indicators for HIV/AIDS clinical care distributed as following: outcome (n=15) and process-related (n=50) indicators; generic (n=36) and HIV/AIDS disease-specific (n=29) indicators; baseline examinations (n=19), screening (n=9), immunization (n=4), prophylaxis (n=5), HIV monitoring (n=16), and therapy (=12) indicators.
There are several studies that set up HIV clinical care indicators, with only a part of them useful to assess the HIV clinical care. More importantly, HIV/AIDS clinical care indicators need to be valid, reliable and most of all feasible.