European Society for Quality in Healthcare, Limerick, Ireland.
Int J Qual Health Care. 2010 Oct;22(5):341-50. doi: 10.1093/intqhc/mzq043. Epub 2010 Aug 13.
Healthcare accreditation has grown rapidly since the 1980s but critics question the value of accreditation rather than certification or inspection. Research has focused more on evidence of impact on provider institutions than on health systems; little has been published on the determinants of growth or decline of accreditation organizations and programmes.
To describe the development of national accreditation organizations in Europe in relation to incentives, funding and market position in 2009; to identify trends over time using data from previous surveys.
Contacts in 24 countries, identified by previous surveys, were invited to complete a web-based questionnaire comprising 183 items seeking numerical data or posing multiple choice options. Preliminary results were verified with respondents and agreed for publication.
National healthcare environment, incentives, government policy, legislation, regulation; programme governance, development, funding.
The survey identified 18 active national accreditation organizations in Europe. Older ones tend to be independent, profession-dominated and self-financing; they have shown little growth in activity and coverage of the potential market. Newer ones have broad stakeholder governance, support from government policy and growth sustained by legal or financial incentives-giving wide coverage across the healthcare system. The traditional collegial model of accreditation is moving towards a semi-regulatory model of external assessment which could integrate minimal standards of licensing, public safety and accountability with aspirational standards for organizational development and improvement.
The principal challenges to sustainable accreditation appear to be market size, consistency of policy support, programme funding and financial incentives for participation.
自 20 世纪 80 年代以来，医疗保健认证迅速发展，但批评人士对认证的价值提出了质疑，而不是对认证或检查提出质疑。研究的重点更多地放在了对提供者机构的影响的证据上，而不是对卫生系统的影响上；关于认证组织和计划的增长或下降的决定因素，发表的内容很少。
描述 2009 年欧洲国家认证组织的发展情况，包括激励措施、资金和市场地位；利用以前调查的数据来确定随时间的趋势。
通过以前的调查确定了 24 个国家的联系人，邀请他们填写一份基于网络的问卷，其中包含 183 个项目，要求提供数字数据或提出多项选择选项。初步结果与受访者进行了核实，并同意发布。
国家医疗保健环境、激励措施、政府政策、立法、监管；计划治理、发展、资金。
调查确定了欧洲 18 个活跃的国家认证组织。较旧的组织往往是独立的，以专业为主导，自筹资金；它们在活动和潜在市场覆盖方面几乎没有增长。较新的组织具有广泛的利益相关者治理、政府政策支持以及法律或财务激励措施的支持，从而在整个医疗保健系统中实现了广泛的覆盖。传统的认证学院模式正在向外部评估的半监管模式转变，这种模式可以将最低限度的许可、公共安全和问责标准与组织发展和改进的理想标准相结合。
可持续认证面临的主要挑战似乎是市场规模、政策支持的一致性、计划资金和参与的财务激励。
