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患者对初级医疗质量的自我评估与基于客观记录的医疗技术质量评估的比较:横断面研究。

Patients' own assessments of quality of primary care compared with objective records based measures of technical quality of care: cross sectional study.

作者信息

Rao Mala, Clarke Aileen, Sanderson Colin, Hammersley Richard

机构信息

Department of Health and Human Sciences, University of Essex, Colchester CO4 3SQ.

出版信息

BMJ. 2006 Jul 1;333(7557):19. doi: 10.1136/bmj.38874.499167.7C. Epub 2006 Jun 22.

Abstract

OBJECTIVE

To investigate the relation between older patients' assessments of the quality of their primary care and measures of good clinical practice on the basis of data from administrative and clinical records.

DESIGN

Cross sectional population based study using the general practice assessment survey.

SETTING

18 general practices in the Basildon primary care trust area, south east England.

PARTICIPANTS

3487 people aged 65 or more.

MAIN OUTCOME MEASURES

Correlations between mean practice scores on the general practice assessment survey and three evidence based measures on survey of case records (monitoring for, and control of, hypertension, and vaccination against influenza).

RESULTS

76% of people (3487/4563) responded to the general practice assessment survey. Correlations between patient assessed survey scores for technical quality and the objective records based measures of good clinical practice were 0.22 (95% confidence interval -0.28 to 0.62) for hypertension monitored, 0.30 (-0.19 to 0.67) for hypertension controlled, and -0.05 (-0.50 to 0.43) for influenza vaccination.

CONCLUSIONS

Older patients' assessments are not a sufficient basis for assessing the technical quality of their primary care. For an overall assessment both patient based and records based measures are required.

摘要

目的

基于行政和临床记录数据,调查老年患者对其初级医疗质量的评估与良好临床实践措施之间的关系。

设计

使用全科医疗评估调查进行的基于人群的横断面研究。

地点

英格兰东南部巴斯尔登初级医疗信托区的18家全科医疗机构。

参与者

3487名65岁及以上的人。

主要观察指标

全科医疗评估调查中的平均机构得分与病例记录调查中三项循证指标(高血压监测、控制以及流感疫苗接种)之间的相关性。

结果

76%的人(3487/4563)对全科医疗评估调查做出了回应。患者评估的技术质量调查得分与基于客观记录的良好临床实践指标之间的相关性,对于高血压监测为0.22(95%置信区间-0.28至0.62),对于高血压控制为0.30(-0.19至0.67),对于流感疫苗接种为-0.05(-0.50至0.43)。

结论

老年患者的评估不足以作为评估其初级医疗技术质量的依据。进行全面评估需要患者和记录两方面的指标。

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