[Quality analysis and evaluation of surgery for herniated lumbar disk. I. Methodology]

A method for the analysis of the quality of the lumbar disc surgery was developed. The method assesses the important quality parameters such as scientific and technical quality (STQ), functional grades, quality of life, patients satisfaction and economic costs. The STQ related to the measurement of the care according to the available medical and technological knowledge was determined according to the performance of explicit criteria and standards in the clinic documentation (PEP method: Performance Evaluation Procedure). To measure the functional grade, a modification of Spanfort's criteria was used. To assess the quality of life a modification of 12-item Short Form health survey was applied. This form includes aspects like pain, social interaction, family characteristics, employment and psychological status. A questionnaire was used to measure satisfaction. The form was previously designed taking into account the patients and professionals criteria. In every stage care given, information issued, management and hosting, the patients and professionals opinions was considered and weighted. To calculate the cost three different systems were proposed i.e., Analytic economic management system (ABC-ABM), Weight related costs of DRGs (Diagnostic Related Groups) and Costs computed from price listing for consulting and hospitalization established by INSALUD.