公开报告质量信息的意外后果
Rachel M Werner1, David A Asch
1Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center;
JAMA
|March 10, 2005
概括
公开报告医疗保健质量数据旨在改善医疗保健,但其有效性尚未得到证实. 潜在的负面后果,如患者选择偏见,可能会破坏质量改善的努力.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高科学 提高质量
背景情况:
- 关于医疗保健质量数据的公开报告旨在推动医生,医院和健康计划绩效的改善.
- 改善的假定机制包括基于质量指标的知情患者选择和医生竞争.
研究的目的:
- 评估公开报告医疗保健质量信息的证明价值.
- 识别公共质量报告的潜在意外负面影响.
主要方法:
- 本研究是对有关公共质量报告的现有文献和证据的批判性审查和分析.
- 该方法包括检查质量报告举措的理论基础和观察到的结果.
主要成果:
- 公共质量报告在改善医疗保健质量的价值仍然在很大程度上未被证明.
- 潜在的负面后果包括医生避免更生病的患者和不适当地遵守干预措施的"目标率".
- 患者的偏好和临床判断可能会被忽视.
结论:
- 虽然公开报告促进了透明度,但其能够明显改善健康结果的能力尚未确立.
- 公共报告可能无意中降低医疗保健质量.
- 需要重新评估公共质量报告在质量改进举措中的作用.
关键词:
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