Botturi Davide, Rodella Stefania
Recenti Prog Med. 2014 Jun;105(6):243-53. doi: 10.1701/1543.16853.
This paper describes the applications of the patient-reported outcome measures, focusing on the National Health Service (NHS) in the United Kingdom. Over the years the use of some related measures has widened, moving from research to clinical practice, and, only recently, to the healthcare quality assessment. The program launched by the United Kingdom Department of Health in April 2009 falls into the latter one, and requires the collection of patient-reported outcome measures for selected surgical procedures (hip or knee replacement, inguinal hernia, varicose veins) within all the health facilities financed by the National Health Service. Several of questionnaires are administered before and after the procedure, thus allowing to assess the health outcomes reported by the patient. From 2009 to 2013, the total number of questionnaires analyzed was high and steadily growing; in the period April 2009-March 2010 184.818 pre-procedure and 134.768 post-procedure questionnaires were completed by the patients and returned, with a 17% and 11% increase, respectively, compared to the previous period (April 2009-March 2010). The analysis of the United Kingdom's experience offers some reflections for the Italian Health Service with regard to some issues, such as the feasibility and the resources, the most appropriate methodology, and the professional culture.
本文介绍了患者报告结局测量的应用,重点关注英国的国民医疗服务体系(NHS)。多年来,一些相关测量的使用范围不断扩大,从研究领域扩展到临床实践,直到最近才应用于医疗质量评估。英国卫生部于2009年4月启动的项目属于后者,该项目要求在国民医疗服务体系资助的所有医疗机构中,收集选定外科手术(髋关节或膝关节置换、腹股沟疝、静脉曲张)的患者报告结局测量数据。在手术前后会发放几份问卷,从而能够评估患者报告的健康结局。2009年至2013年期间,分析的问卷总数很高且稳步增长;在2009年4月至2010年3月期间,患者完成并返回了184,818份术前问卷和134,768份术后问卷,与上一时期(2008年4月至2009年3月)相比,分别增长了17%和11%。对英国经验的分析为意大利医疗服务体系在可行性与资源、最合适的方法以及职业文化等一些问题上提供了一些思考。