在医疗保健中重新考虑措施和死亡率归因:耳鼻科医生的例子
Samip Patel1, Lorenzo Olivero2, Jorge Sinclair De Frias2
1Department of Otorhinolaryngology, Mayo Clinic, Jacksonville, Florida, USA.
概括
国家绩效指标需要准确的患者归因. 这项研究发现,耳鼻喉 (ENT) 死亡率被高估了,突出了改善医疗保健质量测量和报告准确性的需要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健质量测量 医疗保健质量测量
- 患者安全 患者安全
背景情况:
- 国家绩效指标对于患者的决策和医疗保健提供改进至关重要.
- 有效可靠的绩效指标对于准确的医疗保健评估至关重要.
- 目前的死亡率归因方法可能不准确地反映了护理的提供.
研究的目的:
- 为了检查美国新闻和世界报道2012-2019年的指标.
- 评估患者对耳鼻喉 (ENT) 死亡率的归因的准确性.
- 将电子健康记录数据和图表审查与现有的归因方法进行比较.
主要方法:
- 分析美国新闻和世界报告指标 (2012-2019).
- 在三个医院中利用电子健康记录数据和详细的图表审查.
- 被证实的死亡归因于耳鼻喉 (ENT) 死亡组.
主要成果:
- 在最初归因于47例耳鼻喉病例的死亡中,只有23例在详细审查后得到验证.
- 与归因率 (1.7%) 相比,经验证的ENT死亡率明显较低 (0.8%).
- 目前的医疗保险严重性诊断相关组 (MS-DRG) 计费代码可能导致错误的归因.
结论:
- 重新考虑死亡率归因方法是必要的,以提高绩效指标的准确性.
- 目前的专业排名方法可能无法充分捕捉护理的提供.
- 建议转向程序和条件"评级"方法,以改善数据捕获.
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