一个多维的不完整的阶梯试验设计,以估计基于标准的审计审计的影响
Sarah Ann White1, Florence Mgawadere1
1Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
PloS one
|November 30, 2023
概括
临床审计提高了医疗保健的质量,特别是在资源较少的环境中. 这项研究引入了一种新的随机化阶段形试验设计,以不偏地衡量基于标准的审计对医疗保健质量改善的影响.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 临床审计 临床审计
- 孕产妇和新生儿的护理
背景情况:
- 临床审计在改善医疗保健质量方面具有成本效益,但在资源较差的环境中未得到充分利用.
- 产妇和新生儿护理标准已经存在,但它们的实现需要严格的评估.
- 审计前后设计容易产生偏见,因此需要公正的试验设计.
研究的目的:
- 介绍和描述一种新的试验设计,以不偏地估计基于标准的审计的影响.
- 为了解决对改善医疗保健标准的临床审计有效性进行强有力的评估的需要.
- 呈现适用于各种医疗保健环境中的质量改进举措的设计.
主要方法:
- 提出了一个多维不完整的阶梯集群随机试验设计.
- 详细描述了两个阶梯形设计的变体.
- 介绍了使用通用线性混合模型进行样本大小估计和分析的方法.
主要成果:
- 拟议的设计允许对基于标准的审计对合规性的影响进行公正的估计.
- 它使医疗保健提供者能够获得实施审计流程的经验.
- 该设计适用于在不同环境中评估质量改进干预措施.
结论:
- 新型随机阶段形试验设计有效地估计了基于标准的审计对医疗保健标准的影响.
- 这种方法为质量改善研究提供了有价值的工具,特别是在资源有限的环境中.
- 这种可适应的设计有可能用于评估各种医疗保健领域的多种干预措施.
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