A framework for measuring quality and promoting accountability across silos: the case of mental disorders and co-occurring conditions
A framework for measuring quality and promoting accountability across silos: the case of mental disorders and co-occurring conditions
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DOI：
10.1136/qshc.2008.027706
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发表时间：
2010-04-01
影响因子：
--
通讯作者：
Hermann, R. C.
中科院分区：
文献类型：
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作者：
Kilbourne, A. M.;Fullerton, C.;Hermann, R. C.
背景：质量测量是改善医疗服务和患者预后的有效工具。包括一般医疗状况和药物使用障碍在内的共同发生疾病是严重精神健康障碍患者的普遍现象，而不是例外，并导致严重的发病率和死亡率负担。在美国的医疗保健系统中，精神健康障碍患者的COCs通常由单独的系统（“筒仓”）进行治疗，这使得很难建立对绩效的期望，分配对测量结果的问责制，并最终提高对这一群体的护理质量。通过回顾COCs的质量现状和基于Donabedian模型的质量测量实例，提出了衡量COCs护理质量的框架。该框架还将用于更好地确定哪些提供者对质量改进负责，最终确保质量措施对改善COCs的护理产生影响。
Background Quality measures can be effective tools for improving delivery of care and patient outcomes. Co-occurring conditions (COCs), including general medical conditions and substance use disorders, are the rule rather than the exception in patients with serious mental health disorders and lead to substantial morbidity and mortality burden. COCs among persons with mental health disorders are often treated by separate systems ("silos") in the US healthcare system, making it difficult to establish expectations for performance, assign accountability for measure results and ultimately improve quality of care for this group.Objectives A framework for measuring quality of care for COCs is proposed by reviewing the current state of quality for COCs and examples of quality measures based on the Donabedian model.Methods and framework The framework will also be applied to better define which providers are accountable for quality improvement, to ultimately ensure that quality measures have an impact on improving care for COCs.