Patient Safety Activity Under the Social Insurance Medical Fee Schedule in Japan: An Overview of the 2010 Nationwide Survey
Patient Safety Activity Under the Social Insurance Medical Fee Schedule in Japan: An Overview of the 2010 Nationwide Survey
复制标题
日本社会保险医疗费表下的患者安全活动：2010 年全国调查概览
作者：
M. Hirose;Toshihiko Kawamura;Mikio Igawa;Y. Imanaka
目的在日本社会保险医疗费用制度下，患者安全绩效知之甚少。日本厚生省于2006年推出了优惠患者安全对策费（PPSCF），以促进患者安全，并于2010年修订了PPSCF制度。本研究旨在解决实施PPSCF的医院的患者安全性能状态。方法2010 - 2011年对全国2674家开展PPSCF的医院进行问卷调查。627家参与医院被分为以下三组：178家医院实施PPSCF 1，400张床位或更多（A组），286家医院实施PPSCF 1，399张床位或更少（B组），163家医院实施PPSCF 2（C组）。结果A、B、C三组患者安全管理人员的平均数（标准误）分别为1.45（0.07）、1.12（0.04）、0.37（0.12）（P < 0.001）。参加患者安全性研讨会的全体工作人员人数和比例分别为A组1721（167）人和1.64（0.10）人，B组580（26）人和1.94（0.09）人，C组349（31）人和1.98（0.17）人（P < 0.001，P = 0.105）。这些结果可以解释，因为PPSCF 1（A组和B组）的医院必须指定至少一名全职患者安全经理，而PPSCF 2（C组）的医院不需要这样做。PPSCF 1级医院的患者安全性能比PPSCF 2级医院更活跃。然而，当这些值转换为人均或每100张病床时，三组之间没有差异。结论PPSCF通过在日本社会保险医疗费用表下提供激励措施，鼓励医院为患者安全采取行动。
Objectives Little is known about patient safety performance under the social insurance medical fee schedule in Japan. The Health Ministry in Japan introduced the preferential patient safety countermeasure fee (PPSCF) to promote patient safety in 2006 and revised the PPSCF system in 2010. This study aims to address the patient safety performance status at hospitals implementing the PPSCF. Methods A nationwide questionnaire survey targeting 2674 hospitals with the PPSCF was performed in 2010 to 2011. The 627 participant hospitals were divided into the following three groups: 178 hospitals implementing PPSCF 1 with 400 beds or more (group A), 286 hospitals implementing PPSCF 1 with 399 beds or fewer (group B), and 163 hospitals implementing PPSCF 2 (group C). Results The mean numbers (standard errors) of patient safety managers were 1.45 (0.07) in group A, 1.12 (0.04) in group B, and 0.37 (0.12) in group C (P < 0.001). The participation number and rates of all staff for the patient safety seminar were 1721 (167) and 1.64 (0.10) in group A, 580 (26) and 1.94 (0.09) in group B, and 349 (31) and 1.98 (0.17) in group C (P < 0.001, P = 0.105). These results can be explained because hospitals with PPSCF 1 (groups A and B) must assign at least one full-time patient safety manager, whereas hospitals with PPSCF 2 (group C) are not required to do so. Patient safety performance at hospitals with PPSCF 1 was more active than that at hospitals with PPSCF 2. However, when the values were converted to per capita or per 100 beds, there were no differences across the three groups. Conclusions The PPSCF encourages hospitals to perform actions for patient safety by providing incentives under the social insurance medical fee schedule in Japan.
DOI：
10.1097/00132586-199802000-00016
发表时间：
1998-02
期刊：
JAMA
影响因子：
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作者：
D. Bates;N. Spell;D. Cullen;E. Burdick;N. Laird;L. Petersen;S. Small;B. Sweitzer;L. Leape
通讯作者：
D. Bates;N. Spell;D. Cullen;E. Burdick;N. Laird;L. Petersen;S. Small;B. Sweitzer;L. Leape