Siu A L, McGlynn E A, Morgenstern H, Beers M H, Carlisle D M, Keeler E B, Beloff J, Curtin K, Leaning J, Perry B C
Health Sciences Program, RAND, Santa Monica, CA 90407-2138.
Health Serv Res. 1992 Dec;27(5):619-50.
Consumers, payers, and policymakers are demanding to know more about the quality of the services they are purchasing or might purchase. The information provided, however, is often driven by data availability rather than by epidemiologic and clinical considerations. In this article, we present an approach for selecting topics for measuring technical quality of care, based on the expected impact on health of improved quality. This approach employs data or estimates on disease burden, efficacy of available treatments, and the current quality of care being provided. We use this model to select measures that could be used to measure the quality of care in health plans, but the proposed framework could also be used to select quality of care measures for other purposes or in other contexts (for example, to select measures for hospitals). Given the limited resources available for quality assessment and the policy consequences of better information on provider quality, priorities for assessment efforts should focus on those areas where better quality translates into improved health.
消费者、支付方和政策制定者都要求更多地了解他们正在购买或可能购买的服务质量。然而，所提供的信息往往是由数据可用性驱动的，而非出于流行病学和临床方面的考虑。在本文中，我们提出一种基于质量改善对健康的预期影响来选择衡量医疗技术质量主题的方法。该方法利用有关疾病负担、现有治疗方法的疗效以及当前所提供医疗服务质量的数据或估计值。我们使用此模型来选择可用于衡量健康计划中医疗服务质量的指标，但所提议的框架也可用于为其他目的或在其他背景下（例如，为医院选择指标）选择医疗服务质量指标。鉴于用于质量评估的资源有限，以及关于提供者质量的更好信息所产生的政策影响，评估工作的重点应放在那些质量提高能转化为健康改善的领域。
