Evidence map›Paper›PMID 33848340›Full record

ArticleHealth policy and planning2021

Strengthening data collection and use for quality improvement in primary care: the case of Costa Rica.

Madeline Pesec, Lauren Spigel, José María Molina Granados, Asaf Bitton, Lisa R Hirschhorn, Jorge Arturo Jiménez Brizuela, Michael Pignone, María Del Rocío Sáenz, Dan Schwarz, Oscar Villegas Del Carpio and 3 more

Open access · hybridAbstract read
In one paragraph

Article in Health policy and planning, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 2 countries.

Madeline PesecAriadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA.ORCID 0000-0001-6593-200X
Lauren SpigelAriadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA.
José María Molina GranadosDepartment of Quality Assurance, Costa Rican Social Security Administration, Second Avenue between 5th and 7th Street, San José, 10105, Costa Rica.
Asaf BittonAriadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA.
Lisa R HirschhornDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL 60611, USA.
Jorge Arturo Jiménez BrizuelaCosta Rican Social Security Administration, Second Avenue between 5th and 7th Street, San José, 10105, Costa Rica.
Michael PignoneDepartment of Internal Medicine, Dell Medical School University of Texas, 1501 Red River Street, Austin, TX 78712, USA.
María Del Rocío SáenzSchool of Public Health, University of Costa Rica, Calle la Cruz 26, San José, Mercedes, Costa Rica.
Dan SchwarzAriadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA.
Oscar Villegas Del CarpioHealth Service Delivery Strengthening Department, Costa Rican Social Security Administration, Second Avenue between 5th and 7th Street, San José, 10105, Costa Rica.
Ira B WilsonDepartment of Health Services, Policy & Practice, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA.
Eduardo Zamora MéndezCosta Rican Social Security Administration, Second Avenue between 5th and 7th Street, San José, 10105, Costa Rica.
Hannah L RatcliffeAriadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA.
Brigham and Women's Hospital · USCosta Rican Department of Social Security · CRBrown University · USNorthwestern University · USThe University of Texas at Austin · USUniversidad de Costa Rica · CR

Funding

Tracking and Evaluation CoreU54GM115677 · NIGMS · BROWN UNIVERSITY · PI ROUNDS, SHARON IRENE SMITH · 2016 to 2025
$45.0M
NIGMS NIH HHS U54 GM115677
6 · The paper itself

Abstract

Costa Rica is a bright spot of primary healthcare (PHC) performance, providing first-contact accessibility and continuous, comprehensive, coordinated, and patient-centered care to its citizens. Previous research hypothesized that strong data collection and use for quality improvement are central to Costa Rica's success. Using qualitative data from 40 interviews with stakeholders across the Costa Rican healthcare system, this paper maps the various data streams at the PHC level and delineates how these data are used to make decisions around insuring and improving the quality of PHC delivery. We describe four main types of PHC data: individual patient data, population health data, national healthcare delivery data, and local supplementary healthcare delivery data. In particular, we find that the Healthcare Delivery Performance Index-a ranking of the nation's 106 Health Areas using 15 quality indicators-is utilized by Health Area Directors to create quality improvement initiatives, ranging from education and coaching to optimization of care delivery and coordination. By ranking Health Areas, the Index harnesses providers' intrinsic motivation to stimulate improvement without financial incentives. We detail how a strong culture of valuing data as a tool for improving population health and robust training for personnel have enabled effective data collection and use. However, we also find that the country's complex data systems create unnecessary duplication and can inhibit efficient data use. Costa Rica's experience with data collection, analysis, and use for quality improvement hold important lessons for PHC in other public sector systems.

Indexed as

Primary Health CareQuality ImprovementCosta RicaData CollectionDelivery of Health CareHumansCentral AmericaclinicalCosta Ricahealth information systemPrimary careprimary healthcare

Identifiers

PMID33848340
PMCPMC8173660
OpenAlexW3156603811

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.