DEVELOPMENT AND EVALUATION OF A QUALITY ASSESSMENT INSTRUMENT FOR OCCUPATIONAL PHYSICIANS

Objectives-To develop and apply a method for assessing the quality of the process of occupational health care for individual patients. Metho ds-The scientific literature was studied to develop a method to assess the quality of the process of occupational rehabilitation for workers with low back pain. The method was applied to health care and univers ity workers with low back pain who were rehabilitated by their occupat ional physicians. Results-Assessment of quality of care is regarded as a four step approach. Firstly, guidelines should be developed and imp lemented. Secondly, indicators for quality and criteria to demarcate g ood and deviant quality were derived from the guidelines. Thirdly, a m ethod for data collection was chosen. Finally, quality was scored. For occupational rehabilitation, there was some deviance from the guideli nes for most cases, especially in continuity of care with a deviant ra te of 47%. Other indicators deviated from 1.4%-17.4%. Occupational phy sicians agreed on the relevance of the indicators and criteria, but fo r three indicators they evaluated the criteria as too rigid. They did not agree with their own performance scores in 66% of the deviant case s. Conclusion-Assessing the quality of the process of occupational hea lth tare with this method is an asset to present methods, but more spe cific criteria are needed for a more sensitive assessment.