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Table 2 Quality Evaluation QIs in Iran’s Primary Health Care

From: Developing Iranian primary health care quality framework: a national study

Domains

Level

Indicators

Relevance

Importance

Feasibility

Total

references

Access and equity

Structure

1. % of catchment population who received at least one basic visit

84.71

87.06

80.59

84.12

[28]

Process

2. % of patients with mental disorders that have had a follow-up visit in defined period according to national protocol.

80.54

82.16

68.65

77.12

[29]

Outcome

3. % of pregnant women with first visit at the first trimester

94.74

92.63

91.58

92.98

[20]

4. % of population, age 30 to 59 years old with overweight and obesity who received consultation services for behavioral change

90.00

89.47

69.47

82.98

[22]

5. % of smokers, age 18 and older who receive smoking cessation consultation

89.71

88.57

62.29

80.19

[30, 31]

6. % of student age 6 to 14 years old who received florid therapy

90.27

89.19

88.65

89.37

expert panel

7. Clinical staff provide home visits for patients who are physically not able to travel to the practice

76.84

77.37

56.84

70.35

[32]

8. % of individuals with COPD that have had a follow-up visit and treatment during the last year.

79.46

79.46

63.24

74.05

[14]

9. Individual self-care program coverage

Final Expert Panel

safety

Process

10. % of health facility staff immunized for Hepatitis B (3 doses).

84.74

77.89

89.47

84.04

[33]

11. % of safe injections in the health care facility

81.05

82.63

73.16

78.95

[34, 35]

12. % of Staff who have attended continuous training about quality and patient safety during last year

77.78

78.89

79.44

78.70

[36, 37]

13. % compliance with Hand Hygiene guidelines

81.03

77.95

73.33

77.44

[38, 39]

Outcome

14. Number of adverse events reported (immunization/medication)

87.18

88.21

80.51

85.30

[40, 41]

Efficiency

Process

15. % of prescriptions that include antibiotics in health centers and health posts

77.89

78.42

69.47

75.26

[42]

Outcome

16. % of the 13 essential non communicable diseases medicines with no stock out in last 3 months (cardiovascular, diabetes, hypertension and COPD)

82.29

80.57

73.14

78.67

[43]

Effectiveness

Outcome

17. % Hypertension patients with Initial laboratory investigations

80.00

81.05

67.37

76.14

[44,45,46]

18. % of registered hypertension patients with BP < 140/90 at last 2 follow up visits

91.28

90.26

78.46

86.67

[47]

19. % of registered diabetic patients with fasting blood sugar controlled at last 2 follow up visits

94.36

94.36

81.03

89.91

[48, 49]

20. % of registered NCD patients age 30 and older with 10 years’ cardiovascular risk recorded in past 1 year

95.90

92.82

78.97

89.23

[43, 50]

21. % of registered NCD patients with blood pressure recorded twice at last follow up visit

93.33

93.33

83.08

89.91

[43, 51]

22. % children age 6 to 9 months old screened for anemia

85.64

86.67

71.28

81.20

[52, 53]

23. % of women who delivered and received at least once postnatal care within the first 6 weeks

92.31

90.77

82.05

88.38

[54]

24. % of under 23 months children immunized according to the national protocol

96.92

97.44

95.90

96.75

[55]

25. % of people that work in the workshop of under 20 labor worker and whose were basic visit and occupational care in past years.

Final expert panel

26. % of diabetic people with HbA1C less than 7%

92.82

90.77

75.90

86.50

[56, 57]

27. % of pregnant women received at least 6 ANC

89.73

86.49

80.54

85.59

[58]

28. % of under 5 children that had weight and height measured in past 1 year

96.41

93.33

92.82

94.19

[59]

29. % of newborns who are exclusively breastfed for the first six months

93.85

93.33

85.64

90.94

[54]

Patient centeredness

Outcome

30. % of patients aware about Patients’ rights and responsibilities

77.30

75.68

58.92

70.63

[60, 61]

31. Customer satisfaction rate (%)

82.22

87.22

63.89

77.78

[62]

governance

Outcome[55]

32. Staff satisfaction rate

84.24

86.06

69.09

79.80

[63]

33. % of appropriate (upward) referrals during last 6 months (by specific conditions) with appropriate feedback

82.70

82.16

62.16

75.68

[64, 65]

appropriateness

Process

34. % of population, age 30 and older, with diabetes mellitus who received following exams:

 • Hemoglobin A1c (Hba1c);

 • Eye examination;

 • Foot Examination;

 • Blood Pressure Measurement

92.97

93.51

71.89

86.13

[66]

35. % of population, age 20 and older, with depression who received following exams:

 • PHQ

 • Active follow up

 • non-communicable diseases risk factors assessment

 • Drug Side effects assessment

83.68

87.37

62.11

77.72

expert panel

36. % of pregnant women who received health education about:

 • nutritional care

 • anemia

 • sanitation

 • high risk pregnancy signs

94.87

93.85

84.10

90.94

[67,68,69]

Outcome

37. % TB screening in high risk groups

95.14

92.43

83.78

90.45

expert panel

38. % of women aged 30–59 yrs. who had at least 1 Pap test in the past 5 yrs.

87.37

86.32

82.11

85.26

[14]

39. % of risk factors Assessment for AIDS in The population covered.

92.97

93.51

70.27

85.59

expert panel

40. % of water microbial sampling According to standard.

93.51

90.81

90.27

91.53

expert panel