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巴西一家癌症中心头颈肿瘤外科的质量评估与MD安德森癌症中心基准的比较。

Quality assessment in head and neck oncologic surgery in a Brazilian cancer center compared with MD Anderson Cancer Center benchmarks.

作者信息

Lira Renan Bezerra, de Carvalho André Ywata, de Carvalho Genival Barbosa, Lewis Carol M, Weber Randal S, Kowalski Luiz Paulo

机构信息

Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, São Paulo, Brazil.

Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, Texas.

出版信息

Head Neck. 2016 Jul;38(7):1002-7. doi: 10.1002/hed.24304. Epub 2015 Nov 28.

Abstract

BACKGROUND

Quality assessment is a major tool for evaluation of health care delivery. In head and neck surgery, the University of Texas MD Anderson Cancer Center (MD Anderson) has defined quality standards by publishing benchmarks.

METHODS

We conducted an analysis of 360 head and neck surgeries performed at the AC Camargo Cancer Center (AC Camargo). The procedures were stratified into low-acuity procedures (LAPs) or high-acuity procedures (HAPs) and outcome indicators where compared to MD Anderson benchmarks.

RESULTS

In the 360 cases, there were 332 LAPs (92.2%) and 28 HAPs (7.8%). Patients with any comorbid condition had a higher incidence of negative outcome indicators (p = .005). In the LAPs, we achieved the MD Anderson benchmarks in all outcome indicators. In HAPs, the rate of surgical site infection and length of hospital stay were higher than what is established by the benchmarks.

CONCLUSION

Quality assessment of head and neck surgery is possible and should be disseminated, improving effectiveness in health care delivery. © 2015 Wiley Periodicals, Inc. Head Neck 38: 1002-1007, 2016.

摘要

背景

质量评估是评价医疗服务的主要工具。在头颈外科手术中,德克萨斯大学MD安德森癌症中心(MD安德森)通过发布基准来定义质量标准。

方法

我们对AC卡马戈癌症中心(AC卡马戈)进行的360例头颈外科手术进行了分析。这些手术被分为低急症手术(LAPs)或高急症手术(HAPs),并将结果指标与MD安德森的基准进行比较。

结果

在360例病例中,有332例LAPs(92.2%)和28例HAPs(7.8%)。患有任何合并症的患者负面结果指标的发生率更高(p = 0.005)。在LAPs中,我们在所有结果指标上都达到了MD安德森的基准。在HAPs中,手术部位感染率和住院时间高于基准所确定的水平。

结论

头颈外科手术的质量评估是可行的,应该予以推广,以提高医疗服务的有效性。© 2015威利期刊公司。《头颈》第38卷:1002 - 1007页,2016年。

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