Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, AZ Maastricht, the Netherlands.
BMC Psychiatry. 2012 Aug 7;12:103. doi: 10.1186/1471-244X-12-103.
Health care regulatory agencies perform audits or inspections to judge the quality and safety of health care. This judgment is based on the assessment of a large set of health care indicators as accepted by the profession. However, there is a lack of knowledge about the influence of these indicators and whether a smaller number would be sufficient for a quality assessment or audit procedure.
A discrete choice experiment (DCE) was performed for the assessment of quality of care regarding the management of patients with schizophrenia and drug dependency in psychiatric institutes. Based on multidisciplinary guidelines for the treatment of schizophrenia and a visit of (co)inspectors of the Dutch Healthcare Inspectorate at all 33 integrated mental hospitals a set of 51 indicators were assessed in a subsequent interview. With the analysis of the results, 6 attributes were selected for the DCE as quality indicators.
Seventy-six percent of all health services (co)inspectors (n = 33) involved in the inspection of mental health services, participated in the experiment. Respondents considered an operational elaborate treatment plan the most important indicator for the assessment of quality of care in a psychiatric institute, followed by a general care program, treatment outcome measurement, and involvement in treatment of patients and relatives. Pharmacotherapy and governance responsibility were valued as less important indicators.
The results of this DCE show that there is a prioritisation in the six selected quality indicators. This might help health services (co) inspectors to enhance the efficiency and transparency of the quality of care assessment for patients with schizophrenia and/or drug dependency in psychiatric institutes.
医疗保健监管机构进行审计或检查，以判断医疗保健的质量和安全性。这种判断是基于专业人士认可的大量医疗保健指标的评估。然而，人们对这些指标的影响知之甚少，也不知道是否可以用更少的指标来进行质量评估或审计程序。
为评估精神病院管理精神分裂症和药物依赖患者的护理质量，进行了一项离散选择实验（DCE）。根据精神分裂症的多学科治疗指南以及荷兰医疗保健监察局的（共同）视察员对所有 33 家综合精神病院的访问，在随后的访谈中评估了一组 51 项指标。通过对结果的分析，选择了 6 个属性作为 DCE 的质量指标。
参与精神卫生服务检查的所有卫生服务（共同）检查员（n=33）中有 76%参与了实验。受访者认为，在精神病院评估护理质量时，操作复杂的治疗计划是最重要的指标，其次是一般护理方案、治疗结果测量以及对患者和家属的治疗参与。药物治疗和治理责任被视为不太重要的指标。
这项 DCE 的结果表明，在六个选定的质量指标中有一个优先级。这可能有助于卫生服务（共同）检查员提高对精神病院精神分裂症和/或药物依赖患者的护理质量评估的效率和透明度。
