Kind P
Centre for Health Economics, University of York, UK.
Br J Surg. 1990 Dec;77(12):1399-402. doi: 10.1002/bjs.1800771225.
There is a pressing need to develop measures of health outcome for use in medical audit and in shaping decisions on the allocation of resources. Such measurement is not normally performed except in specific research settings. Routine information collected on hospital inpatients contains very crude data on two health outcomes, namely whether such patients were alive or dead at the end of their hospital stay. This paper analyses hospital activity data with particular reference to those patients who had undergone a surgical procedure. The results are broadly consistent with the earlier findings of the Confidential Enquiry into Perioperative Deaths and reveal a crude mortality rate of under 15 deaths per 1000 surgical admissions. Rates as high as 280 per 1000 admissions were found for certain procedures. Since death is a relatively rare health outcome it is argued that the development of a more acceptable measure must be a priority to provide information on the vast majority of surgical patients with non-fatal outcomes.
迫切需要制定用于医疗审计和资源分配决策的健康结果衡量标准。除了在特定的研究环境中，这种测量通常不会进行。收集的关于医院住院患者的常规信息包含了关于两种健康结果的非常粗略的数据，即这些患者在住院结束时是存活还是死亡。本文分析了医院活动数据，特别参考了那些接受过外科手术的患者。结果与围手术期死亡机密调查的早期发现大致一致，显示每1000例外科入院患者的粗死亡率低于15例。某些手术的入院率高达每1000例280例。由于死亡是一种相对罕见的健康结果，因此有人认为，制定一种更可接受的衡量标准必须是优先事项，以便为绝大多数有非致命结果的外科患者提供信息。
