Evaluating the quality of colorectal cancer care across the interface of healthcare sectors.
Evaluating the quality of colorectal cancer care across the interface of healthcare sectors.
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DOI：
10.1371/journal.pone.0060947
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Szecsenyi J
中科院分区：
文献类型：
--
作者：
Ludt S;Urban E;Eckardt J;Wache S;Broge B;Kaufmann-Kolle P;Heller G;Miksch A;Glassen K;Hermann K;Bölter R;Ose D;Campbell SM;Wensing M;Szecsenyi J
结直肠癌(CRC)在西方国家有很高的发病率。结直肠癌的诊断和治疗是复杂的，需要卫生保健部门之间的多学科合作。在德国，一项新的全国性计划旨在提供不同部门的医疗保健服务的高质量信息。在这种情况下，这项研究描述了一套质量指标的发展，该指标描绘了CRC-CARE的整个过程，包括在实践测试之前操作这些指标所必需的数据规范。指标是在一个由13名参与者组成的多学科小组参与的系统的10步修改的“兰德/加州大学洛杉矶分校适当性方法”之后制定的。最后一套指标中的每一项指标都说明了与质量信息来源、数据收集程序、分析和反馈有关的数据规格。最终的指标集包括52项指标，涵盖诊断程序(11项指标)、治疗管理(28项指标)和后续行动(6项指标)。此外，7项指标代表了患者的观点。初次手术肿瘤切除和术前放疗(仅限于直肠癌)被认为是启动高质量数据收集的最有用的示踪程序。为了评估各部门的儿童权利委员会护理质量，确定了各种数据来源：医疗记录、行政住院和门诊数据、疾病基金记账代码系统和患者调查。在德国，已经制定了一套52项质量指标，涵盖了与儿童权利公约保健有关的接口和途径的必要方面。在质量评估中结合不同的卫生保健部门和来源是一种创新和具有挑战性的方法，但更好地反映了患者途径和儿童权利公约护理经验的现实情况。
Colorectal cancer (CRC) has a high prevalence in western countries. Diagnosis and treatment of CRC is complex and requires multidisciplinary collaboration across the interface of health care sectors. In Germany, a new nationwide established program aims to provide quality information of healthcare delivery across different sectors. Within this context, this study describes the development of a set of quality indicators charting the whole pathway of CRC-care including data specifications that are necessary to operationalize these indicators before practice testing. Indicators were developed following a systematic 10 step modified ‘RAND/UCLA Appropriateness Method’ which involved a multidisciplinary panel of thirteen participants. For each indicator in the final set, data specifications relating to sources of quality information, data collection procedures, analysis and feedback were described. The final indicator set included 52 indicators covering diagnostic procedures (11 indicators), therapeutic management (28 indicators) and follow-up (6 indicators). In addition, 7 indicators represented patient perspectives. Primary surgical tumor resection and pre-operative radiation (rectum carcinoma only) were perceived as most useful tracer procedures initiating quality data collection. To assess the quality of CRC care across sectors, various data sources were identified: medical records, administrative inpatient and outpatient data, sickness-funds billing code systems and patient survey. In Germany, a set of 52 quality indicators, covering necessary aspects across the interfaces and pathways relevant to CRC-care has been developed. Combining different sectors and sources of health care in quality assessment is an innovative and challenging approach but reflects better the reality of the patient pathway and experience of CRC-care.
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影响因子：
2.6
作者：
Arah, Onyebuchi A.;Westert, Gert P.;Klazinga, Niek S.
通讯作者：
Klazinga, Niek S.
影响因子：
--
作者：
Campbell, SM;Shield, T;Gask, L
通讯作者：
Gask, L
影响因子：
2.9
作者：
Campbell SM;Kontopantelis E;Hannon K;Burke M;Barber A;Lester HE
通讯作者：
Lester HE
影响因子：
5.3
作者：
Hermens, R. P. M. G.;Ouwens, M. M. T. J.;Wollersheim, H. C. H.
通讯作者：
Wollersheim, H. C. H.
影响因子：
45.3
作者：
Desch, Christopher E.;McNiff, Kristen K.;Edge, Stephen B.
通讯作者：
Edge, Stephen B.