与不良事件和不符合标准的护理相关的医院特征
T A Brennan1, L E Hebert, N M Laird
1Division of General Medicine, Brigham and Women's Hospital, Boston, MA 02115.
JAMA
|June 26, 1991
概括
不良事件 (AE) 和疏忽在各医院之间有很大的差异. 教学和农村医院显示不同的AE率,而少数患者人群与更高的疏忽率有关,这表明质量问题.
科学领域:
- 医疗保健 质量 研究 研究
- 医学错误 流行病学 流行病学
- 医院管理 医院管理
背景情况:
- 副作用 (AEs) 是医疗治疗造成的伤害.
- 了解AEs和疏忽的医院间变化对于质量改善至关重要.
- 以前的质量测量可能没有考虑到患者群体的风险因素.
研究的目的:
- 探索不良事件 (AE) 的流行病学.
- 调查由疏忽引起的AEs的子集.
- 检查AE和疏忽率的医院间变化.
主要方法:
- 1984年从51个随机选择的纽约医院分析了31,000份医疗记录.
- 单变量和多变量分析以确定与AE率和疏忽相关的因素.
- 在不同类型的医院中比较AE率和疏忽百分比.
主要成果:
- 观察到AE率 (0.2%7.9%) 和疏忽率 (1%60%) 的实质性变化.
- 初级教学医院的AE率较高 (4.1%),而农村医院的AE率较低 (1.0%).
- 在教学和营利性医院中,疏忽率较低,但在80%以上的少数民族患者 (37%) 的医院中,疏忽率更高.
结论:
- 事故和疏忽并不是随机分布在医院之间.
- 特定的医院类型和患者人口统计学与更高的医疗伤害率和不合格的护理相关.
- 这些发现提供了通过考虑患者群体风险来改善质量指标.
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