Solberg Leif I, Asche Stephen E, Margolis Karen L, Whitebird Robin R, Trangle Michael A, Wineman Arthur P
HealthPartners Research Foundation and Medical Group, Minneapolis, Minnesota 55440-1524, USA.
Am J Med Qual. 2008 Nov-Dec;23(6):420-6. doi: 10.1177/1062860608324547.
A valid measure of practice systems for improving chronic disease care is needed as a guide for both improvement and public accountability. We tested whether a new survey measure of the presence of practice systems (the PPC-R) is associated with performance measure rates for depression among 40 medical groups in Minnesota. These PPC-R scores were compared with standardized medical group measures of antidepressant persistence. Only 54% of potentially important systems were present, and there was high variability. However, there was a positive correlation between systems and quality on the 90-day measure of antidepressant persistence, both overall (r = .33, P = .04) and for the Chronic Care Model domains of decision support (r = .38, P = .02) and delivery system redesign (r = .31, P = .05). Thus, practice systems overall and several domains of the Chronic Care Model appear to be associated with higher quality care for depression. This questionnaire may help practices identify particular systems to improve.
需要一种有效的实践体系衡量标准来指导慢性病护理的改善以及向公众负责。我们测试了一种新的实践体系存在情况调查指标（PPC-R）是否与明尼苏达州40个医疗集团中抑郁症的绩效指标率相关。将这些PPC-R分数与抗抑郁药持续性的标准化医疗集团指标进行比较。仅存在54%的潜在重要体系，且变异性很大。然而，在抗抑郁药持续性的90天指标上，体系与质量之间存在正相关，总体上（r = 0.33，P = 0.04）以及在决策支持（r = 0.38，P = 0.02）和交付系统重新设计（r = 0.31，P = 0.05）的慢性病护理模型领域中均如此。因此，总体实践体系以及慢性病护理模型的几个领域似乎与更高质量的抑郁症护理相关。这份问卷可能有助于实践机构识别出需要改进的特定体系。
