Outcome Sciences, Cambridge, MA; American Society of Clinical Oncology, Alexandria, VA; Ontario Institute for Cancer Research; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Oncology Hematology Care, Cincinnati, OH.
J Oncol Pract. 2011 May;7(3 Suppl):31s-5s. doi: 10.1200/JOP.2011.000313.
The American health care 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 health care. In 2006, the American Society for 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% v 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% v 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。政府的医保支付方表示，有兴趣与私营部门合作，创建学习社区，以衡量医疗质量并提高医疗保健的价值。2006 年，美国临床肿瘤学会（ASCO）公布了质量肿瘤学实践倡议（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、自愿参与、以实践为基础、以质量改进为目标的项目，通过在美国的肿瘤学实践中进行绩效衡量和基准测试。自成立以来，ASCO 的 QOPI 稳步发展，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。在最近一次 2010 年秋季的数据收集周期中，与首次参与的站点相比，完成多次数据收集周期的实践在疼痛护理方面表现更好（62.61%对 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比例（62.42%对 54.65%）和更高的临终关怀登记率方面表现出明显更好的绩效。QOPI 表明，一个强有力的绩效衡量计划如何能够提高患者的医疗质量和价值。
