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[利用质量指标衡量德国全科医疗服务质量]

[Using quality indicators to measure the quality of general practice care in Germany].

作者信息

Beyer Martin, Chenot Regine, Erler Antje, Gerlach Ferdinand M

机构信息

Institut für Allgemeinmedizin, Goethe-Universität Frankfurt, Frankfurt am Main.

出版信息

Z Evid Fortbild Qual Gesundhwes. 2011;105(1):13-20. doi: 10.1016/j.zefq.2010.09.018. Epub 2010 Oct 8.

Abstract

The publication of two German systems of quality indicators for ambulatory care (AQUIK and QISA) in 2009 stimulated a discussion in German general practice about how to appropriately measure the quality of care in general practice / family medicine. The basic properties and requirements of quality indicators (QIs) in the international literature are discussed in terms of their ability to measure the specific processes of care in general practice. In the second part of the article the QISA system is presented as an example of a methodologically sound development of QIs for ambulatory care for use in both small practices and practice networks. In addition, the context of application and usage of QIs in primary care and the quality control they may provide are discussed. We conclude that important methodological problems have yet to be solved, particularly with measuring 'horizontal' dimensions of quality in primary care (such as comprehensiveness, co-ordination and person-centredness), but that the use of QIs may increase the visibility of general practice in Germany.

摘要

2009年,德国发布了两个门诊医疗质量指标体系(AQUIK和QISA),这引发了德国全科医疗领域对于如何恰当衡量全科医疗/家庭医学护理质量的讨论。国际文献中质量指标(QIs)的基本属性和要求,依据其衡量全科医疗中特定护理过程的能力进行了讨论。在文章的第二部分,介绍了QISA体系,作为一种为门诊医疗合理开发质量指标的方法示例,该体系可用于小型诊所和诊所网络。此外,还讨论了质量指标在初级医疗中的应用背景和使用情况,以及它们可能提供的质量控制。我们得出结论,重要的方法学问题仍有待解决,尤其是在衡量初级医疗质量的“横向”维度(如全面性、协调性和以患者为中心)方面,但质量指标的使用可能会提高德国全科医疗的知名度。

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