Frank B S, Pollack M M
Pediatric Intensive Care Unit, Washoe Medical Center, Reno, NV.
West J Med. 1992 Aug;157(2):149-51.
Unbiased, objective evaluations of quality of care are preferred over subjective evaluations. We observed 681 admissions to a pediatric intensive care unit of a community hospital from 1989 through 1990 for outcomes and physiologic profiles of the patients on the admission day using the Pediatric Risk of Mortality score to assess severity of illness. Mortality adjusted for severity of illness was compared with that predicted from a pediatric intensive care unit of a tertiary medical center: 32.6 deaths were predicted based on the physiologic profiles, and 23 occurred. The number of outcomes and their distribution according to mortality risk indicated close agreement between observed and predicted results. Thus, a quality-assurance technique developed in tertiary care centers can be used to indicate a comparable level of care in a community hospital.
对医疗质量进行无偏见、客观的评估优于主观评估。我们观察了1989年至1990年期间一家社区医院儿科重症监护病房的681例入院病例，利用儿科死亡风险评分评估疾病严重程度，记录患者入院当天的结局和生理特征。将根据疾病严重程度调整后的死亡率与三级医疗中心儿科重症监护病房预测的死亡率进行比较：根据生理特征预测有32.6例死亡，实际发生了23例。结局数量及其根据死亡风险的分布表明观察结果与预测结果高度一致。因此，在三级医疗中心开发的质量保证技术可用于表明社区医院的医疗水平相当。
