Monitoring equity in the delivery of health services: a Delphi process to select healthcare equity indicators
AIMS OF THE STUDY: Health equity is a key component of quality of care and an objective for a growing number of quality improvement projects for deontological, ethical, public health and economic reasons. To monitor equity in the delivery of health services in Switzerland, there is a need to implem...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2024-10-01
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| Series: | Swiss Medical Weekly |
| Online Access: | https://smw.ch/index.php/smw/article/view/3714 |
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| author | Clement P. Buclin Moreno Doninelli Laura Bertini Patrick Bodenmann Stéphane Cullati Arnaud Chiolero Adriana Degiorgi Armin Gemperli Olivier Hugli Anne Jachmann Yves Jackson Joachim Marti Kevin Morisod Katrina A. Obas Florian Rüter Judith Safford Javier Sanchis-Zozaya Matthis Schick Francesca Giuliani Delphine S. Courvoisier |
| author_facet | Clement P. Buclin Moreno Doninelli Laura Bertini Patrick Bodenmann Stéphane Cullati Arnaud Chiolero Adriana Degiorgi Armin Gemperli Olivier Hugli Anne Jachmann Yves Jackson Joachim Marti Kevin Morisod Katrina A. Obas Florian Rüter Judith Safford Javier Sanchis-Zozaya Matthis Schick Francesca Giuliani Delphine S. Courvoisier |
| author_sort | Clement P. Buclin |
| collection | DOAJ |
| description |
AIMS OF THE STUDY: Health equity is a key component of quality of care and an objective for a growing number of quality improvement projects for deontological, ethical, public health and economic reasons. To monitor equity in the delivery of health services in Switzerland, there is a need to implement valid, measurable and actionable equity indicators, along with vulnerability stratifiers such as migrant status, which could lead to differences in quality of care. The aim of this study was to develop a set of healthcare equity indicators and stratifiers targeting inpatient and outpatient populations and to test their feasibility.
METHODS: A scoping literature review and inputs from a national interprofessional expert taskforce provided a set of indicators and vulnerability stratifiers. The most valid and measurable indicators and stratifiers were retained using a Delphi process. They were then operationalised, and their implementation tested in three Swiss hospitals from the three language regions.
RESULTS: A taskforce of 18 experts, including a patient representative, selected 11 indicators that evaluate structures, processes and outcomes, and five vulnerability stratifiers. Although most indicators and stratifiers could be implemented in all three hospitals, data availability was limited for some variables, including patient satisfaction and access to interpreters for foreign-language patients.
CONCLUSIONS: The equity indicators and stratifiers identified by this two-stage process have content validity, wide patient coverage and are focused on inequities in the healthcare system that are actionable through improvement projects. Both the indicators and the project methodology could be replicated in institutions aiming for more equitable care.
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| format | Article |
| id | doaj-art-2dcc2707026a44d7978db58d462e0934 |
| institution | OA Journals |
| issn | 1424-3997 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj-art-2dcc2707026a44d7978db58d462e09342025-08-20T02:18:23ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972024-10-011541010.57187/s.3714Monitoring equity in the delivery of health services: a Delphi process to select healthcare equity indicatorsClement P. Buclin0Moreno Doninelli1Laura Bertini2Patrick Bodenmann3Stéphane Cullati4Arnaud Chiolero5Adriana Degiorgi6Armin Gemperli7Olivier Hugli8Anne Jachmann9Yves Jackson10Joachim Marti11Kevin Morisod12Katrina A. Obas13Florian Rüter14Judith Safford15Javier Sanchis-Zozaya16Matthis Schick17Francesca Giuliani18Delphine S. Courvoisier19Department of Medicine, University of Geneva, SwitzerlandEnte Ospedaliero Cantonale, Lugano, SwitzerlandScuola universitaria professionale della Svizzera italiana, Lugano, Switzerland.Chaire de médecine des populations en situation de vulnérabilité, Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland. Service de Qualité des Soins, Hôpitaux Universitaires de Genève, Geneva, Switzerland. Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland.Ente Ospedaliero Cantonale, Lugano, Switzerland.Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.Psychatric department, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), Lausanne, Switzerland.Universitätsklinik für Notfallmedizin, Inselspital, Universitätsspital Bern, Universität Bern, Schweiz.Service de Médecine de Premier Recours, Hôpitaux Universitaires de Genève, Geneva, Switzerland.Unisanté, Centre universitaire de médecine générale et santé publique, Lausanne, Switzerland. Chaire de médecine des populations en situation de vulnérabilité, Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland.Universitätsspital Zürich, Qualitätsmanagement & Patientensicherheit Rämistrasse 100, 8091 Zürich, Switzerland.Inselspital, Medical Direction, Basel, Switzerland.SCQM Foundation, Zürich, Switzerland.Psychatric department, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), Lausanne, Switzerland.Universitätsspital Zürich, Zürich, Switzerland.Universitätsspital Zürich, Zürich, Switzerland.Service de Qualité des Soins, Hôpitaux Universitaires de Genève, Geneva, Switzerland. AIMS OF THE STUDY: Health equity is a key component of quality of care and an objective for a growing number of quality improvement projects for deontological, ethical, public health and economic reasons. To monitor equity in the delivery of health services in Switzerland, there is a need to implement valid, measurable and actionable equity indicators, along with vulnerability stratifiers such as migrant status, which could lead to differences in quality of care. The aim of this study was to develop a set of healthcare equity indicators and stratifiers targeting inpatient and outpatient populations and to test their feasibility. METHODS: A scoping literature review and inputs from a national interprofessional expert taskforce provided a set of indicators and vulnerability stratifiers. The most valid and measurable indicators and stratifiers were retained using a Delphi process. They were then operationalised, and their implementation tested in three Swiss hospitals from the three language regions. RESULTS: A taskforce of 18 experts, including a patient representative, selected 11 indicators that evaluate structures, processes and outcomes, and five vulnerability stratifiers. Although most indicators and stratifiers could be implemented in all three hospitals, data availability was limited for some variables, including patient satisfaction and access to interpreters for foreign-language patients. CONCLUSIONS: The equity indicators and stratifiers identified by this two-stage process have content validity, wide patient coverage and are focused on inequities in the healthcare system that are actionable through improvement projects. Both the indicators and the project methodology could be replicated in institutions aiming for more equitable care. https://smw.ch/index.php/smw/article/view/3714 |
| spellingShingle | Clement P. Buclin Moreno Doninelli Laura Bertini Patrick Bodenmann Stéphane Cullati Arnaud Chiolero Adriana Degiorgi Armin Gemperli Olivier Hugli Anne Jachmann Yves Jackson Joachim Marti Kevin Morisod Katrina A. Obas Florian Rüter Judith Safford Javier Sanchis-Zozaya Matthis Schick Francesca Giuliani Delphine S. Courvoisier Monitoring equity in the delivery of health services: a Delphi process to select healthcare equity indicators Swiss Medical Weekly |
| title | Monitoring equity in the delivery of health services: a Delphi process to select healthcare equity indicators |
| title_full | Monitoring equity in the delivery of health services: a Delphi process to select healthcare equity indicators |
| title_fullStr | Monitoring equity in the delivery of health services: a Delphi process to select healthcare equity indicators |
| title_full_unstemmed | Monitoring equity in the delivery of health services: a Delphi process to select healthcare equity indicators |
| title_short | Monitoring equity in the delivery of health services: a Delphi process to select healthcare equity indicators |
| title_sort | monitoring equity in the delivery of health services a delphi process to select healthcare equity indicators |
| url | https://smw.ch/index.php/smw/article/view/3714 |
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