Abstract
Purposes
To develop disease-specific quality indicators for patients with low-back-pain presenting to Danish chiropractic clinics.
Methods and results
A cross-disciplinary group of healthcare providers (the indicatorgroup) prioritized nine evidensbased indicators and standards in a systematic consensus process.
A pilot test including 206 low-back-pain patients was carried out in eight chiropractic clinics.
An audit meeting with the test-clinics was conducted after the test-period, and the indicatorgroup designed the final set of indicators.
The indicator domains were: Anamnesis, test for discogenic back pain, neurology, radiology, classification, exercise therapy, outcome assessment (process and result) and re-evaluation.
Two indicators: outcome assessment as a process-indicator (standard ≥ 95 %, standard reached (95% CI): 95.8 % (91.6 – 98.3)) and outcome assessment as a result-indicator (standard ≥ 50 %, standard reached: 67.7 % (59.9 – 74.8)) met the standards set by the indicatorgroup.
After evaluating the test-results the indicatorgroup decided to maintain all nine indicators, however, lowering the standards on anamnesis, discogenic back pain and classification.
Conclusion
It was possible to identify the patient population and collect data with regard to the nine indicators.
At the time being primary care chiropractic clinics in Denmark do not meet the quality standards set by professionals. This may however be partly due to practical problems in the data collecting process.
Both the indicatorgroup and the test-clinics, recommend future nationally widespread implementation of the developed indicators. This could be the first step in joining the Danish healthcare accreditation programme.
Conflicts of interest: None
Sources of funding: The Danish Foundation for Chiropractic Research and Postgraduate Education
