Medical Care Quality Assurance of University Hospitals

我们对6年来接受科研资助的大学教学医院的医疗服务进行了检查。第一个项目是考察日本大学教学医院的组织特点。第二个项目是检查评估大学医院护理质量的方法。本项目旨在通过对高校医院质量保证方案的研究，对高校医院的医疗服务质量进行考核。对如何在组织框架内衡量护理质量的一般框架进行了考察，提出了反映大学医院护理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审查，并根据为审查目的制定的指标进行了分析。该数据还与市级医院（83家）的数据进行了比较。结果表明，高校医院的护理工作具有一定的特点，但各高校医院之间存在一定的差异。大学医院的规模更大，空间更多，每张病床的医生和行政人员更多，解剖率更高，但在其他功能和财务状况方面没有明显差异。在高校医院中，A类所有制医院表现出若干需要改进和进一步研究的地方。特别值得注意的是，关于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.