Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA.
BMJ Qual Saf. 2012 Nov;21(11):964-8. doi: 10.1136/bmjqs-2012-001081. Epub 2012 Aug 14.
External groups requiring measures now include public and private payers, regulators, accreditors and others that certify performance levels for consumers, patients and payers. Although benefits have accrued from the growth in quality measurement, the recent explosion in the number of measures threatens to shift resources from improving quality to cover a plethora of quality-performance metrics that may have a limited impact on the things that patients and payers want and need (ie, better outcomes, better care, and lower per capita costs). Here we propose a policy that quality measurement should be: balanced to meet the need of end users to judge quality and cost performance and the need of providers to continuously improve the quality, outcomes and costs of their services; and parsimonious to measure quality, outcomes and costs with appropriate metrics that are selected based on end-user needs.
外部团体现在需要的措施包括公共和私人支付者、监管机构、认证机构和其他为消费者、患者和支付者认证绩效水平的机构。尽管质量测量的增长带来了好处，但最近衡量指标数量的爆炸式增长有可能将资源从提高质量转移到覆盖大量可能对患者和支付者的需求（即更好的结果、更好的护理和更低的人均成本）产生有限影响的质量绩效指标上。在这里，我们提出了一项政策，即质量测量应该是：平衡的，以满足最终用户判断质量和成本绩效的需求，以及提供者不断提高服务质量、结果和成本的需求；以及节约的，用适当的指标来衡量质量、结果和成本，这些指标是根据最终用户的需求选择的。
