McNeil B J, Pedersen S H, Gatsonis C
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115.
Inquiry. 1992 Fall;29(3):298-307.
Profiling provider performance for the assessment of quality involves a number of issues related to selection of appropriate quality measures, subsequent data collection and analysis, and selection of standards of comparison. This article emphasizes the limitations of current data systems for this purpose and discusses hierarchical modeling as the optimal analytic approach for analyzing resulting data. Mention is made of the difficulties of achieving large enough sample sizes for statistical significance at the individual provider level. Finally, the article discusses feasible options for profiling quality.
评估医疗服务质量时分析医疗服务提供者的表现涉及许多问题，包括选择合适的质量衡量标准、后续的数据收集与分析以及选择比较标准。本文强调了当前用于此目的的数据系统的局限性，并讨论了层次建模作为分析所得数据的最佳分析方法。文中提到了在个体医疗服务提供者层面获得足够大样本量以达到统计学显著性的困难。最后，本文讨论了分析质量的可行选项。
