确保问责制：队列审查方法对纽约市结核病控制的贡献。

Ensuring accountability: the contribution of the cohort review method to tuberculosis control in New York City.

作者信息

Munsiff S S, Ahuja S D, King L, Udeagu C C, Dorsinville M, Frieden T R, Fujiwara P I

机构信息

New York City Department of Health and Mental Hygiene, New York, New York, 10007, USA.

出版信息

Int J Tuberc Lung Dis. 2006 Oct;10(10):1133-9.

PMID:17044207

Abstract

SETTING

In 1993, the New York City (NYC) Bureau of Tuberculosis Control developed the cohort review process as a quality assurance method to track and improve patient outcomes.

METHODS

The Bureau Director reviews every tuberculosis (TB) case quarterly in a multi-disciplinary staff meeting. In 2004 we also began collecting details on issues identified at cohort review to quantify how this process directly impacts TB control efforts.

RESULTS

From 1992 to 2004, NYC TB cases decreased by 72.7% and treatment success rates significantly increased by 26.7%. Implementing the cohort review was key to improving case management, thus leading to these results. For the 1039 patients in 2004, 596 issues were identified among 424 patients; 55.0% were incorrect, unclear or unknown patient information, 13.8% were treatment issues, 12.4% were case management issues and 10.6% were incomplete contact investigations. Most (76.5%) issues were addressed within 30 days of the cohort reviews.

CONCLUSION

A systematic review of every TB case improves the quality of patient information, enhances patient treatment and ensures accountability at all levels of the TB control program.

摘要

背景

1993年，纽约市结核病控制局制定了队列审查流程，作为一种质量保证方法，用于跟踪和改善患者治疗结果。

方法

局长每季度在多学科工作人员会议上审查每一例结核病病例。2004年，我们还开始收集队列审查中发现问题的详细信息，以量化这一流程如何直接影响结核病控制工作。

结果

从1992年到2004年，纽约市的结核病病例减少了72.7%，治疗成功率显著提高了26.7%。实施队列审查是改善病例管理的关键，从而取得了这些成果。2004年的1039名患者中，424名患者存在596个问题；55.0%是患者信息不正确、不清楚或未知，13.8%是治疗问题，12.4%是病例管理问题，10.6%是接触者调查不完整。大多数（76.5%）问题在队列审查后的30天内得到解决。