Evaluation of Healthcare Quality by Practical Clinical Indicators.

为了提高保健质量，据说基于医疗检查过程数据和医疗检查结果数据的评估是重要的。本研究旨在利用DPC等数据，为提高医院医疗服务质量做出贡献（诊断程序组合），并检查基于数据的可客观比较的临床指标。研究小组由医生，医疗检查信息管理员，本研究组织了具有医学检验信息管理或信息分析专业知识和经验的医学检验专家等，对以下几个方面进行了探索：收集DPC相关信息，检查国外病例和国内病例的临床指标，重新安排应基本掌握的临床指标，检查不良事件的定义，结合诊断检查护理判断逻辑的并发症（ICD-10代码），分析有关压疮发生率和再入院率的数据，审查旨在提高医疗保健质量的医院绩效报告，日本医疗质量理事会关于医院功能评价现状的课题等的研究，认为本研究所研究的临床指标和评价方法，虽然在提高数据的准确性等方面还存在问题，但作为有助于提高医疗质量的方法之一是有效的。并且认为医院业绩报告的公布对于促进医院内的活动以提高医疗质量具有效果。这对促进社会计划的研究是有益的。

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.