Evaluation of Healthcare Quality by Practical Clinical Indicators.

为了提高医疗质量，有人说，基于体检过程数据和体检结果数据的评估是重要的。本研究旨在利用DPC(诊断程序组合)等数据，对可根据数据进行客观比较的临床指标进行检验，以促进医院医疗质量的提高。本研究由一名医生、一名体检信息管理人员等具有体检信息管理或信息分析专业知识和经验的研究小组组成。本研究从以下几个方面进行了探索：DPC相关信息的收集、国内外病例临床指标的审查、应基本掌握的临床指标的重新安排、不良事件定义的审查、不良事件定义的审查、结合诊断(ICD-10代码)检验护理判断逻辑的复杂性，分析压疮发生和再住院率的数据，审查针对医疗质量改进的医院绩效报告，审查日本质量保健委员会关于医院功能评估现状的主题等。认为本研究检验的临床指标和评估方法是促进医疗质量提高的有效方法之一，虽然在提高数据准确性等方面还存在问题，但医院绩效报告的公布对促进医院内医疗质量的提高有一定的促进作用。这有利于考察有关社会计划的推进。

For improvement in the quality of health care, it has been said that the evaluation based on the data of the process of medical examination and the data of outcome of medical examination is important. This research is the one having aimed to contribute to the improvement of the quality of hospital medical care by using data, such as DPC (Diagnosis Procedure Combination), and examining the clinical indicators that can be objectively compared of based on data.The research group by a doctor, a medical-examination information manager, etc. who has professional expertise and experience about medical-examination information management or information analysis was organized.In this research, the following was explored : collection of DPC related information, examination of the overseas case and the domestic case regarding clinical indicators, rearrangement of the clinical indicators which it should grasp basically, examination of the definition of adverse event, examination of the complication of care judgment logic by the combination of the diagnosis (ICD-10 code), analysis of data concerning the occurrence of pressure ulcers and re-admission rate, examination of hospital performance report which is directed to the quality improvement of health care, examination concerning the topic and the like of present condition of Hospital Functional Evaluation by Japan Council for Quality Health Care.It is thought that clinical indicators and the evaluation method, which were examined by this research, are effective as one of the methods of contributing to the improvement of the quality of health care, although there is still a problem in the improvement of the data accuracy etc. And it is thought that publication of the hospital performance report has an effect in promotion of the in-hospital activity for improvement in the medical quality. It is beneficial to examine concerning the social plan for promoting.