Zimmerman David R
Center for Health Systems Research and Analysis, University of Wisconsin-Madison, Madison, WI 53709, USA.
Int J Geriatr Psychiatry. 2003 Mar;18(3):250-7. doi: 10.1002/gps.820.
The quality of care provided to nursing home residents is a continuing source of concern throughout the world. In the United States, the Health Care Financing Administration mandated the use of a standardised resident assessment instrument, called the Minimum Data Set (MDS) which facilitated the development of a set of nursing home quality of care indicators.
The MDS Quality Indicators were developed by a team of researchers at the University of Wisconsin-Madison and covered 12 domains, as well as associated risk factors. This initial set of indicators then went through an iterative process of review by national clinical panels, further empirical analysis, validation studies, and pilot tests, to confirm whether they were accurate, reliable and useful tools for identifying quality problems.
The final set of MDS Quality Indicators includes 24 variables that include both processes and outcomes of care and prevalence and incidence measures. They are defined at both the resident and facility level. Four of the indicators are risk-adjusted.
The indicators have several possible applications: a source of consumer information; to help guide policy makers; and to assist providers in conducting quality improvement initiatives and to evaluate the impact of these efforts.
世界各地养老院居民所接受护理的质量一直是令人担忧的问题。在美国，医疗保健财务管理局规定使用一种标准化的居民评估工具，即最低数据集（MDS），这促进了一套养老院护理质量指标的制定。
MDS质量指标由威斯康星大学麦迪逊分校的一组研究人员制定，涵盖12个领域以及相关风险因素。这组初始指标随后经历了一个由国家临床小组进行反复审查、进一步实证分析、验证研究和试点测试的过程，以确认它们是否是识别质量问题的准确、可靠和有用工具。
最终的MDS质量指标集包括24个变量，涵盖护理过程和结果以及患病率和发病率测量。这些指标在居民和机构层面都有定义。其中四个指标经过了风险调整。
这些指标有多种可能的应用：作为消费者信息来源；帮助指导政策制定者；协助提供者开展质量改进举措并评估这些努力的影响。
