在主管医生小组中的质量保证. 强调的地方在哪里?
相关实验视频
E A Kerr1, B S Mittman, R D Hays
1Department of Medicine, University of California, Los Angeles, USA.
JAMA
|October 16, 1996
概括
主管医生团体强调过度使用监测过少使用,并预防性护理超过慢性疾病管理. 质量保证 (QA) 计划需要解决使用不足的问题,特别是在慢性疾病护理中.
科学领域:
- 医疗保健管理的管理
- 质量保证 质量保证 质量保证
- 医生团队运营 医生团队运营
背景情况:
- 资本化模型将质量保证 (QA) 的责任转移到医生团体.
- 医生团体的质量保证计划在重点和有效性上有所不同.
- 了解质量保证活动对于改善资本化系统中的医疗保健服务至关重要.
研究的目的:
- 描述医生集团的质量保证 (QA) 计划.
- 评估QA内部对过度使用与不足使用以及预防与慢性疾病护理的重视.
- 检查医生组特征如何影响质量保证活动.
主要方法:
- 分发给医生组的横截面问卷.
- 研究包括加利福尼亚州一家大型网络型健康维护组织内的94个医生组.
- 收集自报道质量监测和改进方法的数据.
主要成果:
- 所有被调查的医生组都实施了某种形式的质量控制.
- 质量保证计划不成比例地监测过度使用 (例如,剖腹产) 与不足使用 (例如,免疫接种) 相比.
- 预防性服务比慢性疾病后续护理获得了更多的质量保证关注;长寿和利能力等群体特征影响了质量保证活动.
结论:
- 资本化模型将质量保证的重大责任放在医生组上,但覆盖范围不均.
- 资本化的财务激励可能会让人们专注于过度使用,而测量挑战会影响慢性疾病护理监测.
- 建议扩大质量保证计划,包括使用不足的监测,特别是慢性疾病.
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