Institute of Military Health Management, PLA, Faculty of Health Service, The Second Military Medical University, Shanghai, China.
Health Inf Manag. 2012;41(2):22-9. doi: 10.1177/183335831204100203.
The purpose of this study was to build a healthcare quality assessment system with disease category as the basic unit of assessment based on the principles of case classification, and to assess the quality of care in a large hospital in Shanghai. Using the Delphi method, four quality indicators were selected. The data of 124,125 patients discharged from a large general hospital in Shanghai, from October 1, 2004 to September 30, 2007, were used to establish quality indicators estimates for each disease. The data of 51,760 discharged patients from October 1, 2007 to September 30, 2008 were used as the testing sample, and the standard scores of each quality indicator for each clinical department were calculated. Then the total score of various clinical departments in the hospital was calculated based on the differences between the practical scores and the standard. Based on quality assessment scores, we found that the quality of healthcare in departments of thyroid and mammary gland surgery, obstetrics and gynaecology, stomatology, dermatology, and paediatrics was better than in other departments. Implementation of the case classification for healthcare quality assessment permitted the comparison of quality among different healthcare departments.
本研究旨在基于病例分类原则，以疾病类别为评估基本单位，构建医疗质量评估体系，并以上海市某大型综合医院为例进行医疗质量评估。采用德尔菲法，选取了 4 项质量指标。利用 2004 年 10 月 1 日至 2007 年 9 月 30 日期间上海市某大型综合医院出院的 124125 例患者数据，建立了各病种的质量指标估计值。将 2007 年 10 月 1 日至 2008 年 9 月 30 日出院的 51760 例患者数据作为检验样本，计算各临床科室的每个质量指标的标准得分。然后，根据实际得分与标准得分之间的差异，计算医院各临床科室的总分。基于质量评估得分，我们发现甲状腺和乳腺外科、妇产科、口腔科、皮肤科和儿科等科室的医疗质量优于其他科室。实施医疗质量评估的病例分类允许比较不同医疗部门之间的质量。
