Krumholz Harlan M, Keenan Patricia S, Brush John E, Bufalino Vincent J, Chernew Michael E, Epstein Andrew J, Heidenreich Paul A, Ho Vivian, Masoudi Frederick A, Matchar David B, Normand Sharon-Lise T, Rumsfeld John S, Schuur Jeremiah D, Smith Sidney C, Spertus John A, Walsh Mary Norine
J Am Coll Cardiol. 2008 Oct 28;52(18):1518-26. doi: 10.1016/j.jacc.2008.09.004.
The assessment of medical practice is evolving rapidly in the United States. An initial focus on structure and process performance measures assessing the quality of medical care is now being supplemented with efficiency measures to quantify the "value" of healthcare delivery. This statement, building on prior work that articulated standards for publicly reported outcomes measures, identifies preferred attributes for measures used to assess efficiency in the allocation of healthcare resources. The attributes identified in this document combined with the previously published standards are intended to serve as criteria for assessing the suitability of efficiency measures for public reporting. This statement identifies the following attributes to be considered for publicly reported efficiency measures: integration of the quality and cost; valid cost measurement and analysis; minimal incentive to provide poor quality care; and proper attribution of the measure. The attributes described in this statement are relevant to a wide range of efforts to profile the efficiency of various healthcare providers, including hospitals, healthcare systems, managed-care organizations, physicians, group practices, and others that deliver coordinated care.
在美国，医疗实践评估正在迅速发展。最初关注评估医疗质量的结构和过程绩效指标，现在又增加了效率指标，以量化医疗服务的“价值”。本声明基于先前阐述公开报告结果指标标准的工作，确定了用于评估医疗资源分配效率的指标的首选属性。本文件中确定的属性与先前发布的标准相结合，旨在作为评估效率指标是否适合公开报告的标准。本声明确定了公开报告效率指标时应考虑的以下属性：质量与成本的整合；有效的成本测量与分析；提供低质量医疗服务的动机最小化；以及指标的恰当归因。本声明中描述的属性与广泛的评估各种医疗服务提供者效率的工作相关，这些提供者包括医院、医疗系统、管理式医疗组织、医生、团体诊所，以及其他提供协调医疗服务的机构。
