Hong Ji Young, Kang Young Ae
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University Medical Center, Chuncheon, Korea.
Division of Pulmonology, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Tuberc Respir Dis (Seoul). 2018 Jul;81(3):175-186. doi: 10.4046/trd.2017.0093. Epub 2018 Jun 19.
Pneumonia is an important cause of morbidity and mortality. Since 2014, the Health Insurance Review and Assessment Service (HIRA) has assessed the overall quality of care among hospitalized adult patients with community-acquired pneumonia (CAP) provided by all medical institutions in Korea. A committee of the Korea Academy of Tuberculosis and Respiratory Diseases developed the hospital inpatient quality measures set for CAP consisting of eight core measures and five monitoring measures. The composite measure score was calculated. The medical records of hospitalized adult patients ages 18 years or more with CAP from October to December 2014 were evaluated. The data of 523 hospitals (42 tertiary hospitals [8.0%], 256 general hospitals [49%], and 225 hospitals [43.0%]) and 15,432 cases (tertiary hospitals, 1,673 cases [10.8%]; general hospitals, 8,803 cases [57.1%]; hospitals, 4,956 cases [32.1%]) were analyzed. We found large variations among institutions in terms of performance of care measures for CAP. For the composite measure score, the mean value was 66.7 (tertiary hospitals, 98.5; general hospitals, 79.2; hospitals, 43.8). Despite significant differences in measure scores between tertiary, general hospitals and hospitals, no significant differences were found in mortality between hospitals. Further studies are needed to determine the care measures appropriate for CAP.
肺炎是发病和死亡的重要原因。自2014年以来，韩国健康保险审查与评估服务机构（HIRA）对韩国所有医疗机构为成年社区获得性肺炎（CAP）住院患者提供的整体护理质量进行了评估。韩国结核病和呼吸疾病学会的一个委员会制定了针对CAP的医院住院患者质量指标集，包括八项核心指标和五项监测指标。计算了综合指标得分。对2014年10月至12月期间18岁及以上成年CAP住院患者的病历进行了评估。分析了523家医院（42家三级医院[8.0%]、256家综合医院[49%]和225家医院[43.0%]）的数据以及15432例病例（三级医院1673例[10.8%]；综合医院8803例[57.1%]；医院4956例[32.1%]）。我们发现各机构在CAP护理措施的执行方面存在很大差异。对于综合指标得分，平均值为66.7（三级医院为98.5；综合医院为79.2；医院为43.8）。尽管三级医院、综合医院和医院之间的指标得分存在显著差异，但各医院之间的死亡率没有显著差异。需要进一步研究以确定适合CAP的护理措施。
