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确保合理的医疗保健相关感染公共报告系统:系统文献综述与评估建议

Ensuring rational public reporting systems for health care-associated infections: systematic literature review and evaluation recommendations.

作者信息

McKibben Linda, Fowler Gabrielle, Horan Teresa, Brennan P J

机构信息

Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

出版信息

Am J Infect Control. 2006 Apr;34(3):142-9. doi: 10.1016/j.ajic.2005.09.006.

Abstract

BACKGROUND

The Centers for Disease Control and Prevention (CDC) systematically reviewed published studies for the Healthcare Infection Control Practices Advisory Committee (HICPAC) in preparation for guidance to states on mandatory public reporting systems for health care-associated infections (HAI) in hospitals. The HICPAC asked whether public reporting systems are effective in improving health care performance, by measured improvements in clinical processes or patients' health status as the intended outcomes, including but not limited to reduced HAI events; and whether new evidence of effectiveness of private reporting policies to reduce HAI had been published since the 1970s landmark Study on the Efficacy of Nosocomial Infection Control study.

METHODS

Public reporting systems are information provided to the public about the quality of health services. Of 450 published papers reviewed using specific inclusion and exclusion criteria, 10 studies qualified for detailed, protocol-based abstractions.

RESULTS

Findings indicate that the evidence for effectiveness for public reporting systems to improve health care performance is inconclusive. No studies have investigated reduction of HAI as an outcome of public reporting.

CONCLUSION

Rigorous evaluation of mandatory public reporting systems for HAI is recommended to ensure that stakeholders' needs are identified and met.

摘要

背景

美国疾病控制与预防中心(CDC)为医疗保健感染控制实践咨询委员会(HICPAC)系统地审查了已发表的研究,以便为各州制定关于医院医疗保健相关感染(HAI)强制公共报告系统的指南做准备。HICPAC询问公共报告系统是否能通过衡量临床流程或患者健康状况的改善(作为预期结果,包括但不限于减少HAI事件)来有效改善医疗保健绩效;以及自20世纪70年代具有里程碑意义的《医院感染控制效果研究》以来,是否有关于私人报告政策减少HAI有效性的新证据发表。

方法

公共报告系统是向公众提供的有关卫生服务质量的信息。在使用特定纳入和排除标准审查的450篇已发表论文中,有10项研究符合基于方案的详细摘要的条件。

结果

研究结果表明,公共报告系统改善医疗保健绩效有效性的证据尚无定论。没有研究将减少HAI作为公共报告的结果进行调查。

结论

建议对HAI强制公共报告系统进行严格评估,以确保确定并满足利益相关者的需求。

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