Rechel Bernd, McKee Martin, Haas Marion, Marchildon Gregory P, Bousquet Frederic, Blümel Miriam, Geissler Alexander, van Ginneken Ewout, Ashton Toni, Saunes Ingrid Sperre, Anell Anders, Quentin Wilm, Saltman Richard, Culler Steven, Barnes Andrew, Palm Willy, Nolte Ellen
European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H9SH, United Kingdom.
European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H9SH, United Kingdom.
Health Policy. 2016 Apr;120(4):377-83. doi: 10.1016/j.healthpol.2016.02.008. Epub 2016 Feb 26.
This article maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, we found that the data most commonly made available to the public are on waiting times for hospital treatment, being reported for major hospitals in seven countries. Information on patient experience at hospital level is also made available in many countries, but it is not generally available in respect of primary care services. Only one of the 11 countries (England) publishes composite measures of overall quality and safety of care that allow the ranking of providers of hospital care. Similarly, the publication of information on outcomes of individual physicians remains rare. We conclude that public reporting of aggregate measures of quality and safety, as well as of outcomes of individual physicians, remain relatively uncommon. This is likely to be due to both unresolved methodological and ethical problems and concerns that public reporting may lead to unintended consequences.
本文梳理了11个高收入国家(澳大利亚、加拿大、英国、法国、德国、荷兰、新西兰、挪威、瑞典、瑞士和美国)目前在公开报告等待时间、患者体验以及质量与安全综合指标方面的做法。通过对各国主要信息提供者进行问卷调查,我们发现,向公众提供的最常见数据是关于医院治疗的等待时间,七个国家的大型医院都有相关报告。许多国家也提供医院层面的患者体验信息,但初级保健服务方面的此类信息通常没有。11个国家中只有一个国家(英国)公布了护理总体质量和安全的综合指标,以便对医院护理提供者进行排名。同样,关于个体医生治疗结果的信息发布仍然很少。我们得出结论,质量与安全综合指标以及个体医生治疗结果的公开报告仍然相对少见。这可能是由于尚未解决的方法和伦理问题,以及担心公开报告会导致意想不到的后果。