Improving benchmarking by using an explicit framework for the development of composite indicators: an example using pediatric quality of care.
Improving benchmarking by using an explicit framework for the development of composite indicators: an example using pediatric quality of care.
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DOI：
10.1186/1748-5908-5-13
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发表时间：
2010-02-09
期刊：
影响因子：
--
通讯作者：
Petersen LA
中科院分区：
文献类型：
--
作者：
Profit J;Typpo KV;Hysong SJ;Woodard LD;Kallen MA;Petersen LA
对医疗保健提供者绩效的衡量正变得越来越普遍。医生们一直对绩效衡量持谨慎态度，部分原因是护理质量比较衡量的方法还不成熟。全面提高质量将需要全面衡量，这意味着将多个质量衡量标准汇总为综合指标。提出一个概念框架，以制定全面，稳健，透明的儿科护理质量综合指标，并强调儿童质量测量的具体方面。我们回顾了儿科医疗保健环境中综合指标开发、卫生系统和质量测量的科学文献。框架被选择为明确性和适用性，以医院为基础的测量系统。我们将各种框架综合成一个综合模型，用于制定护理质量的综合指标。在其关键前提中，该模型提出了确定结构，过程和结果指标的医学研究所的六个领域的质量（安全性，有效性，效率，以病人为中心，及时性和公平性），并提出了一个逐步的框架嵌入到复合指标的发展护理质量测量模型。提出的框架为研究人员提供了一个明确的路径，综合指标的发展。如果没有一个科学可靠和全面的方法来衡量医疗质量，绩效衡量最终将无法实现其质量改进目标。
The measurement of healthcare provider performance is becoming more widespread. Physicians have been guarded about performance measurement, in part because the methodology for comparative measurement of care quality is underdeveloped. Comprehensive quality improvement will require comprehensive measurement, implying the aggregation of multiple quality metrics into composite indicators. To present a conceptual framework to develop comprehensive, robust, and transparent composite indicators of pediatric care quality, and to highlight aspects specific to quality measurement in children. We reviewed the scientific literature on composite indicator development, health systems, and quality measurement in the pediatric healthcare setting. Frameworks were selected for explicitness and applicability to a hospital-based measurement system. We synthesized various frameworks into a comprehensive model for the development of composite indicators of quality of care. Among its key premises, the model proposes identifying structural, process, and outcome metrics for each of the Institute of Medicine's six domains of quality (safety, effectiveness, efficiency, patient-centeredness, timeliness, and equity) and presents a step-by-step framework for embedding the quality of care measurement model into composite indicator development. The framework presented offers researchers an explicit path to composite indicator development. Without a scientifically robust and comprehensive approach to measurement of the quality of healthcare, performance measurement will ultimately fail to achieve its quality improvement goals.
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