Boehler T, Schaeff B, Hornberg I, Waibel B, Mohrmann M
MDK Baden-Württemberg, BBZ Karlsruhe, Karlsruhe, Germany.
Klin Padiatr. 2009 Jul-Aug;221(4):256-65. doi: 10.1055/s-0029-1224110. Epub 2009 Jul 23.
By the end of the year 2007, pediatric hospitals in Baden-Württemberg had assigned themselves to one of three levels of perinatal care according to a checklist of the German Federal Joint Committee (F-JC) effective since January 1st, 2006. The Medical Service of Statutory Health Insurance had been assigned to prove the plausibility of that self-assessment according to quality criteria for clinical care of term and preterm newborn infants concordated by the F-JC.
Between November 2007 and October 2008 31 providers were audited. Observations were documented in a checklist, reviewed and evaluated by expert auditors. For that purpose, quality criteria given by the F-JC were grouped into 7 quality categories which were weighted according to their practical relevance. In addition, a graded numeric system of evaluation was used for comparative analysis (absolute and relative benchmarking values).
3 of 23 providers fulfilled the quality criteria of the F-JC for PNC level 1 (highest level of care), 6 of 23 fulfilled them in part, and 14 of 23 did not fulfill them as judged by the auditors. Criteria for PNC level 2 were "fulfilled in part" by 2 of 6 providers and "not fulfilled" by 4. Both providers of perinatal special care ("level 3") fulfilled the quality criteria for "level 3" completely. There was no linear correlation between absolute or relative benchmarking values and assessment by expert auditors.
If the criteria of the F-JC were interpreted very strictly, it would be difficult to guarantee comprehensive regional delivery of care in the state of Baden-Württemberg at the level formally requested by the F-JC for PNCs.
截至2007年底，巴登-符腾堡州的儿科医院已根据自2006年1月1日起生效的德国联邦联合委员会（F-JC）的一份清单，将自己归入围产期护理的三个级别之一。法定健康保险医疗服务机构已被要求根据F-JC协调的足月儿和早产儿临床护理质量标准，证明这种自我评估的合理性。
2007年11月至2008年10月期间，对31家医疗机构进行了审核。观察结果记录在一份清单中，由专家审核员进行审查和评估。为此，F-JC给出的质量标准被归为7个质量类别，并根据其实际相关性进行加权。此外，还使用了一个分级数字评估系统进行比较分析（绝对和相对基准值）。
23家医疗机构中有3家符合F-JC的一级围产期护理（最高护理级别）质量标准，23家中有6家部分符合，审核员判断23家中有14家不符合。6家二级围产期护理机构中有2家“部分符合”标准，4家“不符合”。两家围产期特殊护理机构（“三级”）均完全符合“三级”质量标准。绝对或相对基准值与专家审核员的评估之间没有线性相关性。
如果非常严格地解释F-JC的标准，就很难在巴登-符腾堡州按照F-JC对围产期护理正式要求的水平，保证全面的区域护理服务。
