Hung Kuan-Yu, Jerng Jih-Shuin
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Center for Quality Management, National Taiwan University Hospital, Taipei, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Center for Quality Management, National Taiwan University Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2014 Oct;113(10):673-9. doi: 10.1016/j.jfma.2014.06.003. Epub 2014 Aug 5.
Quality measurement is important to stakeholders in providing valid information for improvement, and has been associated with hospital accreditation in most countries. The commonly used categories of indicators are structure, process, and outcome. Outcome indicators are of foremost importance as they reflect the effect of health care; structure indicators are commonly used for assessing capacities or facilities available for providing services, whereas process indicators assess how well the service is delivered, and provide essential and important information for quality improvement. For a process indicator to be valid, it should be linked to an outcome, whereas a structure indicator must be linked to a better outcome. Although there are no strict rules for usage or selection of indicators, it is important to ensure adequate coverage of relevant domains of the health care services intended to be evaluated. Because the trends in health care services and management are changing, it is time to have a paradigm shift in health care quality measurement. Although evaluating the quality had also been extended to include quality of life and patient satisfaction, the ultimate aim of health care services should be "staying healthy, getting healthy, and living healthy". It is important for physicians to learn how to use these clinical indicators for improving service performance and organizational growth.
质量测量对于利益相关者提供有效的改进信息很重要，并且在大多数国家都与医院认证相关。常用的指标类别包括结构、过程和结果。结果指标最为重要，因为它们反映了医疗保健的效果；结构指标通常用于评估提供服务所需的能力或设施，而过程指标则评估服务的提供情况，并为质量改进提供重要信息。要使过程指标有效，它应与结果相关联，而结构指标必须与更好的结果相关联。虽然对于指标的使用或选择没有严格的规则，但确保充分覆盖拟评估的医疗保健服务的相关领域很重要。由于医疗保健服务和管理的趋势在不断变化，现在是时候在医疗保健质量测量方面进行范式转变了。虽然对质量的评估也已扩展到包括生活质量和患者满意度，但医疗保健服务的最终目标应该是“保持健康、恢复健康和健康生活”。医生学习如何使用这些临床指标来提高服务绩效和组织发展很重要。
