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Table 3 Use of EQ-5D-data in quality indicators

From: Collection and use of EQ-5D for follow-up, decision-making, and quality improvement in health care - the case of the Swedish National Quality Registries

Registry

Description of quality indicator

Quality indicators based on outcome measures - published on national platforms

The registry for Better management of patients with OsteoArthritis (BOA)

EQ-5D is being used in two quality indicators showing the proportion of patients with knee and hip osteoarthritis who reach the target level for improved HRQoL 1 year after participation in an osteoarthritis learning programme [43]. An improvement in HRQoL is defined as an absolute increase of 0.1 on the EQ-5D index. The goal is for 30% of the patients to reach this level 1 year after participating in the learning programme.

The Swedish Hip Arthroplasty Register (SHPR)

EQ-5D is being used in the quality indicator “Patient-reported results of total hip arthroplasty” [44]. Previously, the indicator was based on the relationship between the patients’ expected and observed EQ-5D-3L index values 1 year after surgery (Observed results/Expected results × 100). The expected EQ-5D index value was calculated based on the patients’ age, sex, comorbidities, diagnosis, and the EQ-5D measurement before surgery. A value over 100 indicated that the observed result was better than the expected. In 2019, the EQ-5D index value in this indicator was replaced by EQ VAS. EQ-5D results are also reported to the SVEUS platform.

The Swedish Spine Register (SWESPINE)

Absolute and case-mix adjusted EQ-5D index values 1 year after surgery are presented as quality indicators on the SVEUS platform [45].

Quality indicators based on outcome measures - published by the registries

The National Quality Registry for Child and Adolescent Habilitation (HabQ)

The item regarding pain and discomfort in EQ-5D-Y is used in a quality indicator for the follow-up of the habilitation of children with cerebral palsy [46]. The goal is that less than 5 % report severe pain or discomfort at the follow-up point when the children are 9 years old.

The Swedish Neuro Registries – Multiple Sclerosis

The EQ-5D index is used as a quality indicator in the quarterly reports that are sent to the contributing units. The quality indicator represents the proportion of patients in each region with an index value < 0 (defined as worst imaginable), 0–0.5 (poor health), 0.5 < 1 (well, not full health), and 1 (full health).

The National Quality Registry for Dependency (SBR)

The average EQ VAS results are used as a quality indicator in the monthly or quarterly reports to contributing units.

The Swedish Hip Arthroplasty Register (SHPR)

The average increase in EQ VAS score, 1 year after surgery, is used as one out of eight quality indicators in a value compass [31].

The Swedish Heart Failure Registry (SwedeHF)

The average EQ VAS outcome for patients with moderate or pronounced impaired systolic function will be used as a quality indicator for health status in a new online tool that is about to be launched. The results of a set of quality indicators are presented for each of the reporting units.

Quality indicators based on process measures

The National Quality Registry for Podiatric Surgery (RiksFot)

The number of EQ-5D-3L measurements is used in a quality indicator in “Health care in numbers”. The quality indicator represents the proportion of patients who have reported their health with EQ-5D and the Self-reported foot and ankle score (SEFAS) before surgery [47].

National Quality Registry for Systemic Psoriasis Treatment (PsoReg)

The number of EQ-5D-3L measurements (descriptive system) from PsoReg is used by the National Board of Health and Welfare in two quality indicators representing the proportion of persons with severe psoriasis who have received a structured assessment of treatment effects with clinical measures and PROM, each year and 3 to 12 months after initiation of systemic treatment [48]. EQ-5D-3L is one of three instruments that should be included in the structured assessment.

National Quality Registry for Congenital Heart Disease (SWEDCON)

The number of EQ-5D-3L measurements are used in a quality indicator aiming to stimulate the follow-up of the national mission to provide surgery for Grown Up Congenital Heart Disease (GUCH) at Sahlgrenska University Hospital and Skåne University Hospital [49]. The quality indicator summarises the proportion of patients who have had a follow-up regarding their quality of life 6–18 months after surgery.

  1. Note: HRQoL health-related quality of life, PROM Patient-reported outcome measure, VAS visual analogue scale