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 | |||
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 | |||
12. % of Staff who have attended continuous training about quality and patient safety during last year | 77.78 | 78.89 | 79.44 | 78.70 | |||
13. % compliance with Hand Hygiene guidelines | 81.03 | 77.95 | 73.33 | 77.44 | |||
Outcome | 14. Number of adverse events reported (immunization/medication) | 87.18 | 88.21 | 80.51 | 85.30 | ||
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 | |
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 | |||
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 | |||
21. % of registered NCD patients with blood pressure recorded twice at last follow up visit | 93.33 | 93.33 | 83.08 | 89.91 | |||
22. % children age 6 to 9 months old screened for anemia | 85.64 | 86.67 | 71.28 | 81.20 | |||
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 | |||
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 | |
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 | |||
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 | |||
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 |