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Creation of a synthetic indicator of quality of care as a clinical management standard in primary care

Ermengol Coma12*, Manel Ferran3, Leonardo Méndez12, Begoña Iglesias4, Francesc Fina12 and Manuel Medina12

Author Affiliations

1 Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587-589, 08007, Barcelona, Spain

2 IDIAP Jordi Gol (Primary Health Care Research Institute), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain

3 Unitat Docent de Barcelona, Institut Català de la Salut (ICS), c/ Sant Elies 42, 08006, Barcelona, Spain

4 EAP Vilanova 3 CAP Baix a Mar, Consorci de Serveis a les Persones, Plaça Boleranys, 5, 08800, Vilanova i la Geltrú, Spain

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SpringerPlus 2013, 2:51  doi:10.1186/2193-1801-2-51

Published: 13 February 2013



The development of electronic medical records has allowed the creation of new quality indicators in healthcare. Among them, synthetic indicators facilitate global interpretation of results and comparisons between professionals.


A healthcare quality standard (EQA, the Catalan acronym for Estàndard de Qualitat Assistencial) was constructed to serve as a synthetic indicator to measure the quality of care provided by primary care professionals in Catalonia (Spain). The project phases were to establish the reference population; select health problems to be included; define, select and deliberate about subindicators; and construct and publish the EQA.


Construction of the EQA involved 107 healthcare professionals, and 91 health problems were included. In addition, 133 experts were consulted, who proposed a total of 339 indicators. After systematic paired comparison, 61 indicators were selected to create the synthetic indicator. The EQA is now calculated on a monthly basis for more than 8000 healthcare professionals using an automated process that extracts data from electronic medical records; results are published on a follow-up website. Along with the use of the online EQA results tool, there has been an ongoing improvement in most of the quality of care indicators.


Creation of the EQA has proven to be useful for the measurement of the quality of care of primary care services. Also an improvement trend over 5 years is shown across most of the measured indicators.

Health care quality indicators; Primary care; Feedback