Presentation (CTI)

OBJECTIVES: Türkiye’s national clinical quality program has evolved into a centralized, data-driven monitoring system since its formal initiation in 2012.Although the system effectively captures administrative and clinical performance indicators,orthopedic quality assessment remains largely focused on complications and service utilization.As contemporary healthcare systems increasingly emphasize patient-centered outcomes and value-based care,this study aims to examine the structure of Türkiye’s national clinical quality system and evaluate opportunities for integrating patient-reported outcome measures (PROMs),particularly EQ-5D,into orthopedic quality assessment.
METHODS: A structured policy and document review was conducted based on the 2021 Clinical Quality Measurement and Evaluation Guideline and related regulatory documents.The national quality cycle,data architecture, indicator design, and reporting mechanisms were reviewed to assess whether patient-reported outcomes are incorporated.International models of PROM integration in orthopedic registries and national quality systems were also examined to identify alignment opportunities and structural gaps.
RESULTS: The Turkish clinical quality system operates through a five-stage cycle:identification,measurement,evaluation,improvement,and regulation. Clinical data are electronically transferred from hospital information systems to the Ministry of Health’s centralized database,e-Nabız,and analyzed through a Decision Support System. The system integrates demographic data, CD diagnosis codes, DRG codes,SUT procedure codes, and selected clinical parameters. Standardized indicator cards define numerators, denominators, calculation methods, targets, and reporting periods.Current orthopedic indicators for hip and knee arthroplasty mainly assess short-term complications, reoperations, readmissions, and healthcare utilization.While these indicators are important for patient safety monitoring, broader quality dimensions such as pain reduction, mobility improvement, and health-related quality of life are not systematically measured.No routine EQ-5D-based assessment is currently embedded in the national framework.International experience shows that EQ-5D is widely used in arthroplasty registries to measure pre- and post-operative health status, quantify health gain, and support value-based assessment.
CONCLUSIONS: Türkiye’s clinical quality system provides a strong foundation for PROM integration. Incorporating EQ-5D would expand orthopedic quality assessment beyond procedural safety toward measurable health gain,patient-centered evaluation, benchmarking,and value-based healthcare.