利用国家调查数据,在一个大型卫生系统中对综合护理进行基准评估
John S Maier1, Derek Baughman2, Chris Schiermeyer2
1From the University of Pittsburgh, Pittsburgh, PA (JSM, CS, KK); Vanderbilt University, Nashville, TN (DB). jsmaier@pitt.edu.
使用国际疾病分类第10版 (ICD-10) 代码的新措施量化了初级保健的全面性. 这种方法有效地将初级保健与专业保健区分开来,为评估医疗保健提供提供了稳定的参考.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 主要护理医学 医疗保健
- 医疗信息学 医疗信息学
背景情况:
- 初级保健的全面性,定义为医疗保健团队提供的服务的广度,对于患者的治疗结果至关重要.
- 现有的综合性指标有限;本研究引入了一种使用国际疾病分类第10版 (ICD-10) 代码的新方法.
研究的目的:
- 开发和验证基于ICD-10代码分布的初级保健综合性的新方法.
- 评估这一措施是否有能力将初级保健与专科保健区分开来.
主要方法:
- 将来自大量学术卫生系统人口的ICD-10代码分布与国家门诊医疗调查 (NAMCS) 进行了比较.
- 使用线性回归和数学内积来进行比较分析.
- 分析了跨不同专业领域的代码分布.
主要成果:
- 线性回归显示,研究群体的ICD-10代码模式和NAMCS数据之间存在强烈的相关性 (R2=0.62).
- 基于ICD-10代码分布的数学内积有效地区分了初级保健和专科保健.
- 与专科护理相比,初级护理实践显示出ICD-10代码的独特模式.
结论:
- ICD-10代码分布为评估综合护理提供了一种稳定且潜在的可通用方法.
- ICD-10代码分布的内积为区分初级护理和专科护理提供了量化指标.
- 这一新型指标增强了对初级保健提供和综合性的评估.
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