Breckenkamp Juergen, Wiskow Christiane, Laaser Ulrich
University of Bielefeld, School of Public Health, Bielefeld, Germany.
Health Res Policy Syst. 2007 Jun 5;5:7. doi: 10.1186/1478-4505-5-7.
The interest in quality management in health care has increased in the last decades as the financial crises in most health systems generated the need for solutions to contain costs while maintaining quality of care. In Germany the development of quality management procedures has been closely linked with health care reforms. Starting in the early nineties quality management issues gained momentum in reform legislation only 10 years later. This review summarizes recent developments in medical quality management as related to the federal reform legislation in Germany. It provides an overview on the infrastructure, actors and on the current discussion concerning quality management in medical care. Germany had to catch up on implementing quality management in the health system compared to other countries. Considerable progress has been made, however, it is recognized that the full integration of quality management will require long-term commitment in developing methods, instruments and communication procedures. The most ambitious project at present is the development of a comprehensive comparative quality management system for hospitals at national level, including public reporting. For the time being medical quality management in Germany is dealt with as a technical and professional issue while the aspects of patient orientation and transparency need further advancement.
在过去几十年里，随着大多数医疗系统的金融危机引发了在维持医疗质量的同时控制成本的解决方案的需求，医疗保健领域对质量管理的关注度有所提高。在德国，质量管理程序的发展与医疗保健改革密切相关。从九十年代初开始，质量管理问题在改革立法中获得动力仅在10年后。本综述总结了与德国联邦改革立法相关的医疗质量管理的最新发展。它概述了基础设施、参与者以及当前关于医疗保健质量管理的讨论。与其他国家相比，德国在医疗系统中实施质量管理方面不得不迎头赶上。然而，已经取得了相当大的进展，人们认识到质量管理的全面整合将需要在开发方法、工具和沟通程序方面做出长期承诺。目前最雄心勃勃的项目是在国家层面为医院开发一个全面的比较质量管理系统，包括公开报告。目前，德国的医疗质量管理被视为一个技术和专业问题，而以患者为导向和透明度方面需要进一步推进。
