Development of a dementia assessment quality database.

Objective: Increased focus on the quality of health care requires tools and information to address and improve quality. One tool to evaluate and report the quality of clinical health services is quality indicators based on a clinical database.

Method: The Capital Region of Denmark runs a quality database for dementia evaluation in the secondary health system. One volume and seven process quality indicators on dementia evaluations are monitored. Indicators include frequency of demented patients, percentage of patients evaluated within three months, whether the work-up included blood tests, Mini Mental State Examination (MMSE), brain scan and activities of daily living and percentage of patients treated with anti-dementia drugs. Indicators can be followed over time in an individual clinic. Up to 20 variables are entered to calculate the indicators and to provide risk factor variables for the data analyses.

Results: The database was constructed in 2005 and covers 30% of the Danish population. Data from all consecutive cases evaluated for dementia in the secondary health system in the Capital Region of Denmark are entered. The database has shown that the basic diagnostic work-up programme with MMSE, and a brain scan is performed in almost all patients. Differences in the prevalence of etiological diagnoses indicate differences in the application of the diagnostic criteria. This has initiated a process to harmonize the use of diagnostic criteria and the MMSE including administration guide.

Conclusion: Clinical quality indicators based on all patients evaluated for dementia can be used to standardize and harmonize the evaluation process and improve clinical health services.