Quality measurement in orthopaedics: the purchasers' view.
Quality measurement in orthopaedics: the purchasers' view.
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DOI：
10.1007/s11999-009-0999-z
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发表时间：
2009-10
影响因子：
4.2
通讯作者：
Milstein, Arnold
中科院分区：
文献类型：
--
作者：
Lansky, David;Milstein, Arnold
虽然所有的医学都面临着增加透明度和问责制的压力，但关节置换专家将面临特别的审查。对可疑咨询费的披露、人口结构向年轻患者的转变以及在成本压力巨大的时期对产品创新边际效益的不确定性，都促使该行业做出严肃而渐进的回应。国家质量论坛和PQRI目前为标准化措施所做的努力并不能解决购买者、付款人或政策制定者的担忧。相反，他们将要求该行业记录其对适当性、资源管理、护理协调和以患者为中心的承诺。解决这些期望的一种机制是自愿开发统一的关节置换国家登记系统，包括采集术前适当性指标、器械监测信息、翻修率和结构化的术后患者随访。国家登记处应支持绩效反馈和质量改进活动，但其设计也必须满足付款人、购买者、决策者和患者对信息的需求。骨科专业协会应领导一个协作过程，以开发支持持续改进和公共问责制的指标、基础设施和报告格式。
While all of medicine is under pressure to increase transparency and accountability, joint replacement subspecialists will face special scrutiny. Disclosures of questionable consulting fees, a demographic shift to younger patients, and uncertainty about the marginal benefits of product innovation in a time of great cost pressure invite a serious and progressive response from the profession. Current efforts to standardize measures by the National Quality Forum and PQRI will not address the concerns of purchasers, payors, or policy makers. Instead, they will ask the profession to document its commitment to appropriateness, stewardship of resources, coordination of care, and patient-centeredness. One mechanism for addressing these expectations is voluntary development of a uniform national registry for joint replacements that includes capture of preoperative appropriateness indicators, device monitoring information, revision rates, and structured postoperative patient followup. A national registry should support performance feedback and quality improvement activity, but it must also be designed to satisfy payor, purchaser, policymaker, and patient needs for information. Professional societies in orthopaedics should lead a collaborative process to develop metrics, infrastructure, and reporting formats that support continuous improvement and public accountability.
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影响因子：
3.5
作者：
Hauser, DL;Wessinger, SJ;Harris, WH
通讯作者：
Harris, WH
DOI：
10.1002/art.23525
发表时间：
2008-04-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
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通讯作者：
Kim, Sunny
影响因子：
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作者：
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通讯作者：
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影响因子：
0.6
作者：
Gaudiani, VA;Grunkemeier, GL;Wu, YX
通讯作者：
Wu, YX
影响因子：
5.7
作者：
Puvimanasinghe, JPA;Takkenberg, JJM;Bogers, AJJC
通讯作者：
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