Giovannetti Erin R, Dy Sydney, Leff Bruce, Weston Christine, Adams Karen, Valuck Tom B, Pittman Aisha T, Blaum Caroline S, McCann Barbara A, Boyd Cynthia M
Research Scientist, National Committee for Quality Assurance, 1100 13th St NW, Ste 1000, Washington, DC 20005. E-mail:
Am J Manag Care. 2013 Oct 1;19(10):e359-66.
Improving quality of care for people with multiple chronic conditions (MCCs) requires performance measures reflecting the heterogeneity and scope of their care. Since most existing measures are disease specific, performance measures must be refined and new measures must be developed to address the complexity of care for those with MCCs.
To describe development of the Performance Measurement for People with Multiple Chronic Conditions (PM-MCC) conceptual model.
Framework development and a national stakeholder panel.
We used reviews of existing conceptual frameworks of performance measurement, review of the literature on MCCs, input from experts in the multistakeholder Steering Committee, and public comment.
The resulting model centers on the patient and family goals and preferences for care in the context of multiple care sites and providers, the type of care they are receiving, and the national priority domains for healthcare quality measurement.
This model organizes measures into a comprehensive framework and identifies areas where measures are lacking. In this context, performance measures can be prioritized and implemented at different levels, in the context of patients' overall healthcare needs.
提高对患有多种慢性病（MCCs）患者的护理质量需要反映其护理异质性和范围的绩效指标。由于大多数现有指标是针对特定疾病的，因此必须完善绩效指标，并制定新的指标以应对患有MCCs患者护理的复杂性。
描述多种慢性病患者绩效测量（PM-MCC）概念模型的开发过程。
框架开发和全国利益相关者小组。
我们对现有的绩效测量概念框架进行了综述，对有关MCCs的文献进行了综述，收集了多利益相关者指导委员会专家的意见，并征求了公众意见。
最终模型以患者和家庭在多个护理场所和提供者背景下的护理目标和偏好、他们接受的护理类型以及医疗质量测量的国家优先领域为中心。
该模型将指标组织成一个综合框架，并确定了指标缺失的领域。在此背景下，可以根据患者的整体医疗需求，在不同层面确定绩效指标的优先级并加以实施。
