Evaluation of Healthcare Quality by Comparison of Clinical Indicators Among Hospitals

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Basic Clinical Indicators, which could be used at Japanese Hospitals, are developed by researching those of foreign countries. In the mean time, the following was explored : the occurrence of pressure ulcers was surveyed, a comparison among Hospitals was performed, and the problems to use the occurrence of pressure ulcers as a Hospital care indicator were discussed. Through these trials, conclusions regarding the use of clinical indicators as Hospital performance measures are found as follows :1.Effective clinical indicators are not the same among Hospitals because of the different emphasis and function of each Hospital. A set of Basic Clinical Indicators should be developed from which a Hospital can select useful indicators from.2.The manner of calculation of the same indicator should not be different among Hospitals so that the comparisons of indicators be accurate. The method of calculation of indicators should be strictly defined and standardized.3.To correct necessary data to calculate indicators retrospectively would be too much work. Preparing a standardized data form which could be used daily at the work site is recommended for measuring the care quality routinely.4.A data set, which is required to submit for reimbursement under DPC(Diagnosis Procedure Combination), is one of the standardized discharge data set. It seems useful to systematize the certain indicators that can be derived from these data. On the other hand, the data set should be planned to consider the calculation of performance measures.Electrical Medical Record System could be one of the strongest tools for correcting the necessary data to calculate performance measures for the improvement of care quality and efficiency.