Hargraves J L, Palmer R H, Zapka J, Nerenz D, Frazier H, Orav E J, Warner C, Ingard J, Neisuler R
Center for Quality of Care Research and Education, Harvard School of Public Health, Boston, MA 02115.
Clin Perform Qual Health Care. 1993 Oct-Dec;1(4):208-13.
We developed a self-administered patient questionnaire that asks for data concerning the time to receive services (access to care), communication between providers (coordination of care), and follow up after tests and treatment (continuity of care). From these data, we construct rates of performance about the clinical management systems that support provision of these services. Rates of system performance are calculated for indicators using patients' responses to survey questions. These indicators add the number of patients reporting a problem of those patients who have encountered a particular clinical management system. Information derived from 3000 patient questionnaires is matched with data abstracted from health care medical records. The sensitivity and specificity of patient reports are being evaluated for all indicators classified as gold standards for medical records. Indicators considered gold standard items for patient reports are matched for agreement with any information contained in the medical record. Also, patient characteristics associated with accurate reporting is to be assessed using multivariate logistic regression models.
我们开发了一份患者自填问卷，该问卷要求提供有关接受服务时间（获得医疗服务）、医疗服务提供者之间的沟通（医疗服务协调）以及检查和治疗后的随访（医疗服务连续性）的数据。根据这些数据，我们构建了关于支持提供这些服务的临床管理系统的绩效比率。使用患者对调查问题的回答来计算指标的系统绩效比率。这些指标将报告问题的患者数量添加到遇到特定临床管理系统的患者中。从3000份患者问卷中获得的信息与从医疗保健病历中提取的数据相匹配。正在对所有被归类为病历黄金标准的指标评估患者报告的敏感性和特异性。被视为患者报告黄金标准项目的指标与病历中包含的任何信息进行匹配以达成一致。此外，将使用多元逻辑回归模型评估与准确报告相关的患者特征。
