Centre for Patient Safety and Service Quality, Faculty of Medicine, Imperial College London, Room 508 Medical School Building, St Mary's Campus, Norfolk Place, W2 1PG London, UK.
Int J Qual Health Care. 2013 Feb;25(1):1-7. doi: 10.1093/intqhc/mzs079. Epub 2013 Jan 4.
Being able to compare hospitals in terms of quality and safety between countries is important for a number of reasons. For example, the 2011 European Union directive on patients' rights to cross-border health care places a requirement on all member states to provide patients with comparable information on health-care quality, so that they can make an informed choice. Here, we report on the feasibility of using common process and outcome indicators to compare hospitals for quality and safety in five countries (England, Portugal, The Netherlands, Sweden and Norway).
The cross-country comparison identified the following seven challenges with respect to comparing the quality of hospitals across Europe: different indicators are collected in each country; different definitions of the same indicators are used; different mandatory versus voluntary data collection requirements are in place; different types of organizations oversee data collection; different levels of aggregation of data exist (country, region and hospital); different levels of public access to data exist; and finally, hospital accreditation and licensing systems differ in each country.
Our findings indicate that if patients and policymakers are to compare the quality and safety of hospitals across Europe, then further work is urgently needed to agree the way forward. Until then, patients will not be able to make informed choices about where they receive their health care in different countries, and some governments will remain in the dark about the quality and safety of care available to their citizens as compared to that available in neighbouring countries.
能够比较不同国家医院的质量和安全性有很多原因。例如，2011 年欧盟关于患者跨境医疗保健权利的指令要求所有成员国向患者提供可比的医疗质量信息，以便他们能够做出明智的选择。在这里，我们报告了使用通用流程和结果指标来比较五个国家（英国、葡萄牙、荷兰、瑞典和挪威）的医院质量和安全性的可行性。
跨国比较确定了以下七个关于比较欧洲医院质量的挑战：每个国家收集的指标不同；相同指标的定义不同；强制性和自愿性数据收集要求不同；监督数据收集的组织类型不同；数据的聚合级别（国家、地区和医院）不同；数据的公众访问级别不同；最后，医院认证和许可制度在每个国家都不同。
我们的研究结果表明，如果患者和政策制定者要比较欧洲医院的质量和安全性，那么迫切需要进一步努力达成前进的方向。在那之前，患者将无法就他们在不同国家接受医疗保健的地点做出明智的选择，一些政府对其公民可获得的护理质量和安全性将仍然一无所知，与邻国相比。
