A conceptual framework for the OECD health care quality indicators project
A conceptual framework for the OECD health care quality indicators project
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DOI：
10.1093/intqhc/mzl024
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发表时间：
2006-09-01
影响因子：
2.6
通讯作者：
Klazinga, Niek S.
中科院分区：
文献类型：
--
作者：
Arah, Onyebuchi A.;Westert, Gert P.;Klazinga, Niek S.
问题。经济合作与发展组织 (OECD) 的医疗保健质量指标 (HCQI) 项目旨在制定一套用于比较 OECD 成员国医疗保健质量的指标，需要一个平衡的概念框架，概述该项目当前和后续阶段应捕获的主要概念和绩效领域。解决问题。本文为 OECD 的 HCQI 项目制定了概念框架。它首先认为，开发这样一个框架应该首先解决“执行什么以及达到什么目的？”这个问题。我们确定了至少两个不同的主要框架类别：（i）健康和（ii）医疗保健绩效框架，这两种框架都很常用。对于 HCQI，我们提出了一个概念框架，该框架主要是对现有绩效框架的有目的的修改，并由健康决定因素模型驱动。结论。绩效框架的概念基础可以追溯到健康决定因素模型。健康绩效框架对健康决定采取更广泛的社会或公共卫生观点，而医疗保健绩效则对与健康（需求）相关的医疗保健采取更狭隘的、主要是临床或技术的观点。本文提出了一个 HCQI 框架，该框架侧重于医疗保健质量，对健康及其其他决定因素保持更广泛的视角，并认识到卫生政策的主要目标。
Issues. The Health Care Quality Indicator (HCQI) Project of the Organization for Economic Cooperation and Development (OECD), which is aimed at developing a set of indicators for comparing the quality of health care across OECD member countries, requires a balanced conceptual framework that outlines the main concepts and domains of performance that should be captured for the current and subsequent phases of the project.Addressing the issues. This article develops a conceptual framework for the OECD's HCQI Project. It first argues that developing such a framework should start by addressing the question, 'performance of what-and to what ends?' We identify at least two different major classes of frameworks: (i) health and (ii) health care performance frameworks, both of which are in common use. For the HCQI, we suggest a conceptual framework that is largely a purposeful modification of the existing performance frameworks and which is driven by the health determinants model.Conclusions. The conceptual basis for performance frameworks can be traced back to the health determinants model. A health performance framework takes a broader, societal or public health view of health determination, whereas a health care performance takes a narrower, mostly clinical or technical view of health care in relation to health (needs). This article proposes an HCQI framework that focuses on the quality of health care, maintains a broader perspective on health and its other determinants, and recognizes the key aims of health policy.