Meneghelo Romeu Sergio, Morhy Samira Saady, Zucchi Paola
Hospital Israelita Albert Einstein Sao Paulo, Sao Paulo, SP, Brasil.
Grupo Interdepartamental de Economia da Saude, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brasil.
Arq Bras Cardiol. 2014 Feb;102(2):151-5. doi: 10.5935/abc.20140005.
The search for quality requires assessment tools in the various subdivisions of a health complex. In diagnostic medicine, they are scarce and in ergometry suggestions of indicators were not found.
To establish indicator for quality control on ergometry based on III Guidelines of the Brazilian Cardiology Society About Ergometric Test; to verify the percentage of tests that have presented the indicator within the compliance in two services of the same institution before and after the publication of the document.
A critical analysis of the guidelines in the search for indicator that would present: accuracy, reliability, simplicity, validity, sensitivity and ability to quantitatively measure the variations in the behavior of quality criteria and that would be applicable to all tests. The indicator was applied in tests of 2010 and 2011 prior to the publication, and after it was adopted by two services of the same institution.
The indicator that has met the criteria was the percentage of ergometric tests with exercise duration between 8 and 12 minutes. In the years 2010 and 2011, respectively, the percentage of ergometric tests within compliance were 85.5% and 86.1% (p=0.068) at the General Hospital, and 81.5% and 85.7% (p<0.001) the Service of Periodic Health Assessment.
The exercise time between 8 and 12 minutes can be used as a quality criterion in ergometric and services where it was applied, at least 80% of the ergometric tests were compliant.
对医疗综合机构各个细分领域的质量评估需要相应的评估工具。在诊断医学中,此类工具较为匮乏,而在运动负荷测试方面,尚未发现有关指标的相关建议。
依据巴西心脏病学会关于运动负荷测试的第三版指南,制定运动负荷测试质量控制指标;核实该文件发布前后,同一机构的两个科室中符合该指标的测试所占百分比。
对指南进行批判性分析,以寻找具备准确性、可靠性、简易性、有效性、敏感性以及能够定量测量质量标准行为变化且适用于所有测试的指标。该指标在文件发布前应用于2010年和2011年的测试中,并在同一机构的两个科室采用该指标后再次应用。
符合标准的指标是运动持续时间在8至12分钟之间的运动负荷测试的百分比。在总医院,2010年和2011年符合标准的运动负荷测试百分比分别为85.5%和86.1%(p = 0.068);在定期健康评估科室,这一百分比分别为81.5%和85.7%(p < 0.001)。
8至12分钟的运动时间可作为运动负荷测试的质量标准,在应用该标准的科室中,至少80%的运动负荷测试符合标准。