Gilson L, Kitange H, Teuscher T
Health Policy Unit, London School of Hygiene and Tropical Medicine.
Health Policy. 1993 Dec;26(2):119-39. doi: 10.1016/0168-8510(93)90114-5.
Process quality is the commonly used operational definition of health care quality. Its key components are technical and inter-personal skills, but most assessments undertaken in developing countries focus only on technical skills. This study from Tanzania used explicit observation checklists to review the process of providing antenatal, curative and nursing care in primary health units, assessing both technical and inter-personal skills. The study findings emphasize the weaknesses in available care, particularly in the attitudes of health staff but also in aspects of technical care. Differences in performance between health units appear to be influenced by factors such as workloads, structure and staff allocations. Differences between cadres were also identified and may underlie some of the inter-unit differences. The policy actions required to address the problems must reflect the diversity of the underlying influences, seeking to raise both technical and inter-personal quality, as the two are mutually reinforcing.
过程质量是医疗保健质量常用的操作性定义。其关键组成部分是技术和人际技能，但在发展中国家进行的大多数评估仅关注技术技能。这项来自坦桑尼亚的研究使用明确的观察清单来审查初级卫生单位提供产前、治疗和护理服务的过程，评估技术和人际技能。研究结果强调了现有护理的弱点，特别是卫生工作人员的态度，以及技术护理方面的弱点。卫生单位之间的绩效差异似乎受到工作量、结构和人员分配等因素的影响。还发现了不同干部之间的差异，这可能是单位间差异的部分原因。解决这些问题所需的政策行动必须反映潜在影响的多样性，力求提高技术和人际质量，因为两者相辅相成。
