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Evaluation of Healthcare Quality by Comparison of Clinical Indicators Among Hospitals

通过医院临床指标比较评价医疗质量

基本信息

批准号：
14370772
负责人：
UMESATO Yoshimasa
金额：
$ 6.72万
依托单位：
Nihon University School of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2002
资助国家：
日本
起止时间：
2002 至 2004
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14370772/
关键词：
Clinical Indicator Performance Measure Japan Minimum Data set Outlier Analysis Pressure ulcer クリニカルインディケーター

项目摘要

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.

通过研究国外的基本临床指标，开发出可在日本医院使用的基本临床指标。同时，对压疮的发生情况进行了调查，并进行了医院间比较，对压疮发生率作为医院护理指标存在的问题进行了探讨。通过这些试验，对临床指标作为医院绩效评价指标的研究发现：1.由于各医院的侧重点和功能不同，有效的临床指标也不尽相同。建立一套临床基本指标体系，供医院从中选择有用的指标。2.同一指标的计算方法不应因医院而异，以保证指标比较的准确性。指标的计算方法应严格界定和规范。3.对必要的数据进行修正以追溯计算指标的工作量太大。建议编制一个标准化的数据表，可以每天在工作现场使用，以衡量护理质量的必要性。4.一个数据集，这是需要提交的DPC（诊断程序组合）下的报销，是标准化的出院数据集之一。将可以从这些数据中推导出的某些指标系统化似乎很有用。另一方面，数据集的规划应考虑到绩效指标的计算，电子病历系统可以成为一个最强大的工具，用于纠正必要的数据，以计算绩效指标，提高护理质量和效率。