von Wichmann Miguel Ángel, Locutura Jaime, Blanco José Ramón, Riera Melchor, Suárez-Lozano Ignacio, Saura Rosa María, Vallejo Paula
Hospital Donostia, San Sebastián, España.
Enferm Infecc Microbiol Clin. 2010 Nov;28 Suppl 5:6-88. doi: 10.1016/S0213-005X(10)70048-3.
Spain has some tradition of quality assurance systems, although less than in Anglo-Saxon countries. However, there is scarce implantation of these systems in the field of HIV infection. While this scarcity could be explained by the uncertainty surrounding the disease at the beginning of the epidemic, for several years there has been solid scientific evidence on many features of the approach to this disease, established in the various treatment and clinical practice guidelines. Consequently, the AIDS Study Group [Grupo de Estudio del Sida (GESIDA)] designed the present quality of care indicators for persons with HIV/AIDS. The first draft was developed by a committee of health professionals, with the guidance of the Avedis Donebadian University Institute. This draft was then evaluated by a team of external reviewers and posted on the Web page of the Society's web page. Some of the suggestions were included in the final document, with 66 indicators (structure: 5, process: 45, results: 16) in the following areas: structural conditions, diagnosis and evaluation, follow-up and preventive interventions, follow-up of patients under treatment, specific aspects in women, comorbidities, hospitalization, mortality rates, training and research. In each indicator, the sections guaranteeing the indicators' validity and reliability are specified: justification of the indicator as a measure of quality, the healthcare dimension evaluated, mathematical formula, explanation of terms, population, type of indicator (structure, process result), data source, the standard to be achieved and commentaries on the validity of the indicator. Finally, 22 indicators deemed relevant were chosen. GESIDA believes that these indicators should be constantly monitored in all HIV units to identify their results at all times and thus be able to introduce improvement measures.
西班牙有一些质量保证体系的传统，尽管不如盎格鲁 - 撒克逊国家那么完善。然而，这些体系在艾滋病毒感染领域的应用却很少。虽然这种稀缺性可以用疫情初期围绕该疾病的不确定性来解释，但多年来，在各种治疗和临床实践指南中已经有了关于该疾病治疗方法诸多特征的可靠科学证据。因此，艾滋病研究小组[西班牙艾滋病研究协作组（GESIDA）]设计了目前针对艾滋病毒/艾滋病患者的护理质量指标。初稿由一个卫生专业人员委员会在阿维迪斯·唐贝迪安大学研究所的指导下制定。然后，该初稿由一组外部评审员进行评估，并发布在该协会的网页上。一些建议被纳入了最终文件，最终文件包含66项指标（结构：5项，过程：45项，结果：16项），涉及以下领域：结构条件、诊断与评估、随访与预防性干预、接受治疗患者的随访、女性的特定方面、合并症、住院治疗、死亡率、培训与研究。在每个指标中，都明确了保证指标有效性和可靠性的部分：指标作为质量衡量标准的理由、所评估的医疗保健维度、数学公式、术语解释、人群、指标类型（结构、过程、结果）、数据来源、要达到的标准以及关于指标有效性的注释。最后，选择了22项被认为相关的指标。GESIDA认为，所有艾滋病毒治疗单位都应持续监测这些指标，以便随时了解其结果，从而能够采取改进措施。
