Leonardi Michael J, McGory Marcia L, Ko Clifford Y
Department of Surgery, The David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Arch Surg. 2007 Sep;142(9):863-8; discussion 868-9. doi: 10.1001/archsurg.142.9.863.
To explore hospital comparison Web sites for general surgery based on: (1) a systematic Internet search, (2) Web site quality evaluation, and (3) exploration of possible areas of improvement.
A systematic Internet search was performed to identify hospital quality comparison Web sites in September 2006. Publicly available Web sites were rated on accessibility, data/statistical transparency, appropriateness, and timeliness. A sample search was performed to determine ranking consistency.
Six national hospital comparison Web sites were identified: 1 government (Hospital Compare [Centers for Medicare and Medicaid Services]), 2 nonprofit (Quality Check [Joint Commission on Accreditation of Healthcare Organizations] and Hospital Quality and Safety Survey Results [Leapfrog Group]), and 3 proprietary sites (names withheld). For accessibility and data transparency, the government and nonprofit Web sites were best. For appropriateness, the proprietary Web sites were best, comparing multiple surgical procedures using a combination of process, structure, and outcome measures. However, none of these sites explicitly defined terms such as complications. Two proprietary sites allowed patients to choose ranking criteria. Most data on these sites were 2 years old or older. A sample search of 3 surgical procedures at 4 hospitals demonstrated significant inconsistencies.
Patients undergoing surgery are increasingly using the Internet to compare hospital quality. However, a review of available hospital comparison Web sites shows suboptimal measures of quality and inconsistent results. This may be partially because of a lack of complete and timely data. Surgeons should be involved with quality comparison Web sites to ensure appropriate methods and criteria.
基于以下方面探索普通外科的医院比较网站：（1）系统的互联网搜索；（2）网站质量评估；（3）探索可能的改进领域。
2006年9月进行了系统的互联网搜索，以识别医院质量比较网站。对公开可用的网站在可访问性、数据/统计透明度、适用性和及时性方面进行评级。进行了抽样搜索以确定排名的一致性。
识别出六个全国性医院比较网站：1个政府网站（医疗保险和医疗补助服务中心的医院比较网站）、2个非营利性网站（医疗保健组织认证联合委员会的质量检查网站和跨跃集团的医院质量与安全调查结果网站）以及3个商业网站（名称未提及）。在可访问性和数据透明度方面，政府和非营利性网站表现最佳。在适用性方面，商业网站表现最佳，它们使用过程、结构和结果指标相结合的方式比较多种外科手术。然而，这些网站均未明确界定诸如并发症等术语。两个商业网站允许患者选择排名标准。这些网站上的大多数数据都有两年或更久的历史了。对4家医院的3种外科手术进行的抽样搜索显示存在显著不一致性。
接受手术的患者越来越多地利用互联网比较医院质量。然而，对现有医院比较网站的审查显示质量衡量标准欠佳且结果不一致。这可能部分是由于缺乏完整和及时的数据。外科医生应参与质量比较网站，以确保采用适当的方法和标准。
