Nicholas D D, Heiby J R, Hatzell T A
Center for Human Services, Bethesda, MD 20814.
Qual Assur Health Care. 1991;3(3):147-65. doi: 10.1093/intqhc/3.3.147.
Persistently excessive morbidity and mortality rates in less developed countries (LDCs) served by primary health care systems suggest that the quality of services is inadequate. The PRICOR project, sponsored by the United States Agency for International Development, has designed and implemented methods for quality assessment and problem solving in LDC health systems. After developing comprehensive lists of essential activities and tasks, similar to practice parameters, for seven child survival interventions, PRICOR supported comprehensive quality assessment studies in twelve LDC countries. The studies, yielding over 6000 observations of health worker-client encounters, indicated highly prevalent, serious program deficiencies in areas including diagnosis, treatment, patient education and supervision. To facilitate corrective action, PRICOR assisted managers in conducting operations research to resolve priority problems revealed by the assessments. The recently initiated Quality Assurance Project is building on PRICOR techniques in designing and implementing sustainable continuous quality improvement programs for LDC health systems.
由初级卫生保健系统服务的欠发达国家（LDCs）持续存在过高的发病率和死亡率，这表明服务质量不足。由美国国际开发署赞助的PRICOR项目，设计并实施了欠发达国家卫生系统质量评估和问题解决方法。在为七项儿童生存干预措施制定了类似于实践参数的基本活动和任务综合清单之后，PRICOR在12个欠发达国家支持了全面的质量评估研究。这些研究产生了6000多次卫生工作者与患者接触的观察结果，表明在诊断、治疗、患者教育和监督等领域存在非常普遍且严重的项目缺陷。为了促进采取纠正行动，PRICOR协助管理人员进行运筹学研究，以解决评估中发现的优先问题。最近启动的质量保证项目正在PRICOR技术的基础上，为欠发达国家卫生系统设计和实施可持续的持续质量改进项目。
