Quality of Care in Chronic Leg Ulcer in the Community: Introduction of Quality Indicators and a Scoring System

Background: Treatment of chronic wounds is complex, particularly as a standard for the assessment and evaluation of quality of care is missing. Objectives: To develop indicators for quality of care in chronic wounds in general, and to evaluate the quality of care in leg ulcers in Hamburg, Germany, in particular. Methods: Twenty indicators were derived from a national Delphi expert consensus to compute a single index of quality of care. This index was applied in a cross-sectional study involving a large spectrum of care providers and leg ulcer patients in the community. Trained wound experts interviewed and examined the patients, who had to complete standardized questionnaires. Results: On average, 64% of the quality criteria were met in the consecutive sample of 502 patients with chronic leg ulcers of any origin; 75% of the patients were satisfied with their wound care. Predictors of quality of care are presented. Conclusions: This instrument is feasible, valid and ready for comparisons of patient groups, regions and care systems, and for optimization processes in wound care. Copyright (C) 2011 S. Karger AG, Basel