Hospital quality: a PRIDIT approach.
Hospital quality: a PRIDIT approach.
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医院质量：PRIDIT 方法。
DOI：
10.1111/j.1475-6773.2007.00821.x
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发表时间：
2008
影响因子：
3.4
通讯作者：
Lieberthal,RobertD
中科院分区：
文献类型：
--
作者：
Lieberthal,RobertD
背景。获得高质量的医疗服务是健康结果的重要决定因素，但医疗质量难以确定。目的：应用prit方法，利用个别过程测量确定医院质量的总体相对度量。设计：使用prit方法对医疗保险医院数据进行回顾性分析。向CMS医院比较数据库报告数据的四千二千七十七家急症护理和危重医院。措施。报告了四类二十个质量措施：心脏病发作护理、心力衰竭护理、肺炎护理和手术感染预防，以及五种医院类型的结构性措施。结果：相对医院质量分布紧密，有非常高和非常低质量的异常值。医院质量的最佳指标是因心力衰竭而接受左心室功能评估的患者、入院时接受β受体阻滞剂治疗的患者和因心脏病发作而出院时接受β受体阻滞剂治疗的患者。结论：priditi允许我们使用流程度量和医院的人口统计属性对医院的护理质量进行排名。这种方法是一种替代使用临床结果措施，以衡量医院的质量。医院质量措施应考虑到不同质量指标的差异值，包括医院的“人口”变量。
Background.Access to high quality medical care is an important determinant of health outcomes, but the quality of care is difficult to determine.Objective.To apply thePRIDITmethodology to determine an aggregate relative measure of hospital quality using individual process measures.Design.Retrospective analysis of Medicare hospital data using thePRIDITmethodology.Subjects.Four‐thousand‐two‐hundred‐seventeen acute care and critical access hospitals that report data to CMS'Hospital Comparedatabase.Measures.Twenty quality measures reported in four categories: heart attack care, heart failure care, pneumonia care, and surgical infection prevention and five structural measures of hospital type.Results.Relative hospital quality is tightly distributed, with outliers of both very high and very low quality. The best indicators of hospital quality arepatients given assessment of left ventricular functionfor heart failure andpatients given β‐blocker at arrivalandpatients given β‐blocker at dischargefor heart attack. Additionally, teaching status is an important indicator of higher quality of care.Conclusions.PRIDITallows us to rank hospitals with respect to quality of care using process measures and demographic attributes of the hospitals. This method is an alternative to the use of clinical outcome measures in measuring hospital quality. Hospital quality measures should take into account the differential value of different quality indicators, including hospital “demographic” variables.