Outcome Sciences, 201 Broadway, 5th Floor, Cambridge, MA 02139, USA.
Am J Manag Care. 2011 May;17 Suppl 5 Developing:SP32-6.
The American healthcare system, including the cancer care system, is under pressure to improve patient outcomes and lower the cost of care. Government payers have articulated an interest in partnering with the private sector to create learning communities to measure quality and improve the value of healthcare. In 2006, the American Society of Clinical Oncology (ASCO) unveiled the Quality Oncology Practice Initiative (QOPI), which has become a key component of the measurement system to promote quality cancer care. QOPI is a physician-led, voluntary, practice-based, quality-improvement program, using performance measurement and benchmarking among oncology practices across the United States. Since its inception, ASCO's QOPI has grown steadily to include 973 practices as of November 2010. One key area that QOPI has addressed is end-of-life care. During the most recent data collection cycle in the fall of 2010, those practices completing multiple data collection cycles had better performance on care of pain compared with sites participating for the first time (62.61% vs 46.89%). Similarly, repeat QOPI participants demonstrated meaningfully better performance than their peers in the rate of documenting discussions of hospice and palliative care (62.42% vs 54.65%) and higher rates of hospice enrollment. QOPI demonstrates how a strong performance measurement program can lead to improved quality and value of care for patients.
美国的医疗保健系统，包括癌症护理系统，面临着提高患者治疗效果和降低医疗成本的压力。政府付款方表示有兴趣与私营部门合作，建立学习社区，以衡量质量并提高医疗保健的价值。2006 年，美国临床肿瘤学会（ASCO）公布了质量肿瘤实践倡议（QOPI），这已成为促进癌症护理质量的衡量体系的重要组成部分。QOPI 是一个由医生主导的、自愿的、基于实践的质量改进计划，利用美国各地肿瘤学实践的绩效衡量和基准测试。自成立以来，ASCO 的 QOPI 稳步增长，截至 2010 年 11 月，已包括 973 个实践。QOPI 解决的一个关键领域是临终关怀。在 2010 年秋季最近一次数据收集周期中，那些完成多次数据收集周期的实践在疼痛护理方面的表现优于首次参与的站点（62.61%比 46.89%）。同样，重复参与 QOPI 的实践在记录临终关怀和姑息治疗讨论方面的表现明显优于同行（62.42%比 54.65%），并具有更高的临终关怀参与率。QOPI 展示了一个强大的绩效衡量计划如何能够提高患者护理的质量和价值。
