Dickinson D M, Shearon T H, O'Keefe J, Wong H-H, Berg C L, Rosendale J D, Delmonico F L, Webb R L, Wolfe R A
Scientific Registry of Transplant Recipients, University Renal Research and Education Association, University of Michigan, USA.
Am J Transplant. 2006;6(5 Pt 2):1198-211. doi: 10.1111/j.1600-6143.2006.01275.x.
Measuring and monitoring performance--be it waiting list and posttransplant outcomes by a transplant center, or organ donation success by an organ procurement organization and its partnering hospitals--is an important component of ensuring good care for people with end-stage organ failure. Many parties have an interest in examining these outcomes, from patients and their families to payers such as insurance companies or the Centers for Medicare and Medicaid Services; from primary caregivers providing patient counseling to government agencies charged with protecting patients. The Scientific Registry of Transplant Recipients produces regular, public reports on the performance of transplant centers and organ procurement organizations. This article explains the statistical tools used to prepare these reports, with a focus on graft survival and patient survival rates of transplant centers--especially the methods used to fairly and usefully compare outcomes of centers that serve different populations. The article concludes with a practical application of these statistics--their use in screening transplant center performance to identify centers that may need remedial action by the OPTN/UNOS Membership and Professional Standards Committee.
衡量和监测绩效——无论是移植中心的等待名单和移植后结果,还是器官获取组织及其合作医院的器官捐赠成功率——都是确保为终末期器官衰竭患者提供优质护理的重要组成部分。许多方面都有兴趣审视这些结果,从患者及其家属到保险公司或医疗保险和医疗补助服务中心等支付方;从提供患者咨询的初级护理人员到负责保护患者的政府机构。移植受者科学登记处定期发布关于移植中心和器官获取组织绩效的公开报告。本文解释了用于编制这些报告的统计工具,重点是移植中心的移植物存活率和患者存活率——特别是用于公平且有效地比较服务不同人群的中心的结果的方法。本文最后介绍了这些统计数据的实际应用——它们在筛选移植中心绩效以识别可能需要器官移植受者网络/器官共享联合系统会员和专业标准委员会采取补救行动的中心方面的用途。