Integral indicators of the quality of medical care – the way to build a high-quality health care system of Ukraine and the implementation of the best global practices for evaluating the effectiveness of health care technologies

Abstract

Background. About 60% of deaths from treatable conditions are caused by poor health care, while the remaining deaths result from failure to use the health care system. High-quality health systems can prevent 2.5 million deaths from cardiovascular disease, 1 million newborn deaths, 900,000 deaths from tuberculosis and half of all maternal deaths each year. Wasting resources and catastrophic costs are economic side effects of low-quality health care systems. As a result, only one quarter of people in low- and middle-income countries believe their health systems are working well. Purpose – to summarize the current information on approaches to the indicative assessment of the quality of medical care. Materials and Methods. Publications were selected based on the databases PubMed, Clinical Key Elsevier, Cochrane Library, eBook Business Collection, and Google Scholar, which covered information on the assessment of the quality of medical care. At the first stage, literature sources were searched for Keywords: quality of medical care, quality measurement, quality indicators. At the second stage, summaries of articles were studied and publications that did not meet the research criteria were excluded. At the third stage, the full texts of the selected articles were studied for compliance with the criteria for inclusion in the literature list and research relevance. Results. Clinical quality of care is related to the interactions between health care providers and patients and the ways in which health system data are translated into health outcomes. The problem of insufficient efficiency of medical service providers, and as a result insufficient coverage of high-quality medical care, is particularly acute in low- and middle-income countries. According to the Organization for Economic Cooperation and Development, among low- and middle-income countries, Ukraine is one of the countries with a below-average income. The National Health Service of Ukraine, which was established in December 2017, acts as the central executive body that implements state policy in the field of state financial guarantees of medical care for the population under the program of medical guarantees. Quality indicators are measurement tools used for quantitative assessment of effectiveness, safety and/or patient orientation. The terms «indicator» and «indicator» are often used interchangeably, but in the context of quality, it is more appropriate to use the term «quality indicator» for measures that are accompanied by evaluation. Many quality measurement systems form a large number of quality indicators, which made it necessary to develop methods of combining various indicators into the so-called integral quality indicators (IQI). The most important component of the successful creation of a highly accurate and statistically acceptable IiY is the normalization of individual indicative indicators that are part of it by applying weighting factors. Conclusions. Integral quality indicators are aimed at reducing individual quality indicators to a single final indicator. A key assumption underlying the use of integral indicators is that the component parts together provide a fair summary of the whole.