Joffe J
Eval Health Prof. 1980 Dec;3(4):421-33. doi: 10.1177/016327878000300406.
Numerous problem areas were encountered in the evaluation of a voluntary second surgical opinion program. Some problems could be handled only on a conceptual level, while others require for their solution the integration of existing with new data sets. (1) Reliance on program participants to provide medical data was sensitivity tested and found to have minimal impact. (2) Program impact on hospital bed reduction was considered in the context of the total market and political environment in the region, and the anticipated duration of the program. A reasonable judgment was that almost the entire fixed component in the per diem cost of anticipated patient days foregone could be written off as part of the cost savings of the program. (3) As hospital reporting systems identify only average per diem costs, a methodology was developed to separate surgical from nonsurgical case costs. (4) Quality of care evaluation will incorporate a substratum of cases for which there exists a control group within the program user population. Outcome measures obtainable through survey interviews were identified.
在评估一项自愿性二次手术意见项目时遇到了许多问题领域。一些问题只能在概念层面上处理，而其他问题则需要将现有数据集与新数据集整合才能解决。(1) 对项目参与者提供医疗数据的依赖进行了敏感性测试，发现影响极小。(2) 在该地区的整体市场和政治环境以及项目预期持续时间的背景下，考虑了项目对减少医院床位的影响。一个合理的判断是，预期节省的患者日每日费用中几乎全部固定部分都可作为项目成本节约的一部分注销。(3) 由于医院报告系统仅识别每日平均成本，因此开发了一种方法来区分手术病例成本和非手术病例成本。(4) 护理质量评估将纳入项目用户群体中有对照组的病例子样本。确定了可通过调查访谈获得的结果指标。
