通过更好的质量测量来实现对正义,公平,多样性和包容性的可持续方法
Nkem Okeke1,2, Kerrilynn C Hennessey3, Amy M Sitapati4
1Medicalincs, Silver Spring, MD (N.O.).
Circulation. Cardiovascular quality and outcomes
|April 15, 2024
概括
电子临床质量测量 (eCQM) 被广泛使用,但未能考虑健康和人口变化的社会决定因素. 这限制了它们在改善健康平等和解决差距方面的有效性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 医疗信息学 医疗信息学
背景情况:
- 美国医疗保健系统广泛使用来自电子健康记录 (EHR) 的绩效和质量指标,与支付激励相关.
- 这些措施旨在改善健康状况,增加预期寿命并降低医疗保健成本.
- 当前的质量指标往往反映了平均表现,并没有充分调整人口多样性和健康的社会决定因素 (SDOH).
研究的目的:
- 分析电子临床质量测量 (eCQM) 的现状和未来状况.
- 通过健康公平的镜头来检查eCQMs.
- 突出需要改善健康状况报告工具的细节性,复杂性和标准化.
主要方法:
- 讨论和分析有关eCQM的现有文献和行业实践.
- 检查当前eCQM在解决人口多样性和SDOH方面的局限性.
- 探讨人口变化对医疗保健绩效指标的影响.
主要成果:
- 现有的eCQM虽然是一个基本步骤,但缺乏必要的调整以应对人口差异和SDOH.
- 目前用于捕捉健康状况的工具缺乏地方卫生水平改善所需的细节化和标准化.
- 诸如种族,族裔和SDOH等因素对医疗保健绩效的影响是显著的,但目前的指标没有充分解决.
结论:
- 发展eCQM至关重要,以纳入SDOH和人口因素,以实现更公平的医疗保健系统.
- 提高细节性,复杂性和标准化对于开发有效的工具来解决健康差异至关重要.
- 未来的eCQM开发必须优先考虑公平,以真正改善所有人群的健康结果.
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