Objectives:

Chronic Obstructive Pulmonary Disease (COPD) is a common health problem to be dealt with in primary care. Little is known about the quality of care provided for patients with COPD in Germany. Therefore, we wanted to assess the current quality of care delivered by a primary care network (PCN) for patients with COPD.

Methods:

A cross-sectional study was conducted in collaboration with a primary care network (PCN). All patients of the PCN aged 40 years and older with a diagnosis of COPD were identified through electronic health records (EHR). A set of quality indicators (QIs) developed in accordance with current COPD-guidelines were appraised through numerical data retrieved from the EHR.

Results:

In total, 2,568 patients with COPD were identified. Their mean age was 67 (SD±12) years, 49% were male. Thirty-five percent had a parallel diagnosis of asthma. There was no documentation of any spirometry for 54% of patients; 29% had a spirometry within the previous year. An influenza vaccination was documented for 37% within the preceding 12 months; 12% received a pneumococcal vaccination in the last 6 years. Smoking status was documented for 44% within the last year.

Conclusion:

The quality of care for patients with COPD in the PCN seemed suboptimal, despite the presence of a Disease Management Program (DMP). This finding is likely to apply widely to German general practice. Quality assessment through currently available EHR data was challenging due to non-standardized and insufficient documentation.

中文翻译：

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德国全科医学中慢性阻塞性肺病 (COPD) 护理的质量——一项横断面研究

 目标：

慢性阻塞性肺疾病（COPD）是初级保健中需要处理的常见健康问题。人们对德国为慢性阻塞性肺病患者提供的护理质量知之甚少。因此，我们想要评估初级保健网络 (PCN) 目前为慢性阻塞性肺病 (COPD) 患者提供的护理质量。

 方法：

与初级保健网络（PCN）合作进行了一项横断面研究。所有年龄在 40 岁及以上、诊断为 COPD 的 PCN 患者均通过电子健康记录 (EHR) 进行识别。通过从 EHR 检索的数值数据评估了根据当前 COPD 指南制定的一组质量指标 (QI)。

 结果：

总共确定了 2,568 名 COPD 患者。他们的平均年龄为 67 (SD±12) 岁，其中 49% 为男性。百分之三十五的人同时被诊断为哮喘。 54% 的患者没有任何肺量测定记录； 29% 的人在前一年内进行过肺活量测定。据记录，37% 的人在过去 12 个月内接种过流感疫苗； 12% 的人在过去 6 年内接受过肺炎球菌疫苗接种。去年有记录的 44% 的人有吸烟状况。

 结论：

尽管有疾病管理计划 (DMP)，但 PCN 中 COPD 患者的护理质量似乎并不理想。这一发现可能广泛适用于德国的一般实践。由于非标准化和文档不足，通过当前可用的 EHR 数据进行质量评估具有挑战性。