Medical Care Quality Assurance of University Hospitals

我们审查了过去6年来接受科研补助金的大学教学医院的医疗服务。第一个项目是研究日本大学教学医院的组织特征。第二个项目是研究方法，以评估在大学医院的护理质量。本课题以大学医院的质量保证项目为研究对象，对大学医院的医疗质量进行了研究，对如何在组织框架内衡量医疗质量的一般框架进行了研究，并提出了反映大学医院医疗质量和质量保证的指标。我们还对从69所大学医院收集的数据进行了广泛的检查，并根据为我们的检查目的而开发的指标进行了分析，还将数据与市立医院的数据（83）进行了比较。研究结果显示了大学医院护理的一些特点，以及大学医院之间的一些差异。大学医院的规模较大，空间较大，床位医师和管理人员较多，尸检率较高，但在其他功能和财务状况方面无显著性差异，在大学医院中，A类所有制医院存在一些需要改进和进一步研究的地方。特别注意有关大学医院教学活动的数据不足。我们提出了几项建议，包括统一的出院摘要和公布收集到的有关大学医院护理质量的数据。

We have examined medical care of university teaching hospitals for past 6 years receiving grant-in-aid for scientific research. First project was to examine organizationed characteristics of Japanese university teaching hospitals. Second project was to examine methodology to evaluate quality of care given at university hospitals. This project is to conclude the examination of care given at university hospitals by making research aiming quality assurance program of university hospitals.We have made examination on general framework of how to measure quality of care within organizational framework and propose some indicators reflecting quality and quality assurance of care given by university hospitals. We also have made extensive examination of data collected from 69 university hospitals and analyzed by indicators developed for our examination purposes.The data is also compared with those of municipality hospitals(83). The results shows some characteristics of care given at university hospitals together with some differences among university hospitals. University hospitals are bigger in sizes and have more spaces as well as more physicians and administrative staffs per bed and showshigher autopsy rate,but no notable differences in other functions as well as financial situation are observed.Among University hospitals,Type A ownership hospitals show several points needing improvement and further examination. Special attention is given to insufficient data concerning teaching activities of university hospitals. We have made several recommendations including uniformed discharge summary and publication of collected data concerning quality of care of university hospitals.