滥用行为索赔数据作为质量改进工具. II. II. II. II. II. II. II. II. II. II. II. II. II. II. II. II. II. II. 定位是有效的吗?
J E Rolph1, R L Kravitz, K McGuigan
1RAND Corporation, Santa Monica, CA 90406-2138.
JAMA
|October 16, 1991
概括
错误执业索赔数据为识别容易犯错误的医生提供了有限的预测能力. 虽然专科和医院因素会影响错误概况,但仅仅索赔史是针对性干预的不足.
科学领域:
- 医疗失误研究 医疗失误研究
- 改善医疗保健质量 改善医疗保健质量
- 医生的绩效分析分析.
背景情况:
- 错误执业索赔数据是识别医生疏忽和相关因素的潜在来源.
- 了解错误模式对于改善患者安全和医疗实践至关重要.
研究的目的:
- 评估失职索赔数据在识别倾向于犯疏忽错误的医生的有用性.
- 确定与特定类型的医疗错误相关的医生和医院特征.
主要方法:
- 从一个大型的新泽西州医师失职保险公司 (1977-1989) 的失职索赔记录的回顾性审查.
- 分析了来自产科/妇科,整体外科,麻醉学和放射学医生的索赔数据.
- 索赔被分为11种临床错误类型 (患者管理,技术性能,人员协调).
主要成果:
- 使用5年的历史来预测长期索赔倾向,其准确性不高 (根据专业的概率高出11%-57%).
- 医生专业是医生特征中错误概况的唯一显著预测因素.
- 医院的大小,位置和服务可以预测急性护理机构索赔的错误概况 (准确率为69%).
结论:
- 错误实践索赔历史只有中等的预测能力,使它们成为针对医生进行教育或制裁的问题.
- 需要进一步的研究来完善有效利用索赔数据以提高质量的方法.
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