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制定质量支付计划的病理学措施——第一部分:寻找有意义的措施。

Developing Pathology Measures for the Quality Payment Program-Part I: A Quest for Meaningful Measures.

机构信息

From the Department of Pathology, University of Colorado-Anschutz Medical Campus, Aurora (Dr Bocsi); the Department of Pathology, NorthShore University Health System, Evanston, Illinois (Dr Kang); the Advocacy Division, College of American Pathologists, Washington, DC (Mss Kennedy, Singh, and Peditto); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Cardona). Ms Kennedy is currently with the American Society of Clinical Oncology, Arlington, Virginia.

出版信息

Arch Pathol Lab Med. 2020 Jun;144(6):686-696. doi: 10.5858/arpa.2019-0377-OA.

Abstract

CONTEXT.—: Quality measures assess health care processes, outcomes, and patient perceptions associated with high-quality health care, which is commonly defined as care that is effective, safe, efficient, patient centered, equitable, and timely. Such measures are now being used in order to incentivize provision of high-quality health care.

OBJECTIVE.—: To meet the goals of the Quality Payment Program, quality measures will be developed from clinical practice guidelines and relevant, peer-reviewed research identifying evidence that the measure addresses 3 areas: a high-priority aspect of health care or a specific national health goal or priority; a meaningful focus, such as leading to a desired health outcome; and a gap or variation in care.

DESIGN.—: Within the College of American Pathologists (CAP), the Measures and Performance Assessment Subcommittee is tasked with developing useful performance measures. Participating practitioners can then select measures that are meaningful to their respective patients and practices, and reflect the quality of the services they provide.

RESULTS.—: The CAP developed 23 quality measures for reporting to the Centers for Medicare & Medicaid Services that reflect rigorous clinical evidence and address areas in need of performance improvement.

CONCLUSIONS.—: Because the implications of reporting on these pathology-specific metrics are significant, these measures and the process by which they were designed are presented here in peer-reviewed fashion. The measures described in this article (part 1) represent recent efforts by the CAP to develop meaningful measures that reflect rigorous clinical evidence and highlight areas with opportunities for performance improvement.

摘要

背景

质量措施评估与高质量医疗保健相关的医疗保健流程、结果和患者感知,高质量医疗保健通常定义为有效、安全、高效、以患者为中心、公平和及时的医疗保健。目前正在使用这些措施来激励提供高质量的医疗保健。

目的

为了实现质量支付计划的目标,质量措施将根据临床实践指南和相关的、经过同行评审的研究制定,这些研究确定了该措施解决以下三个方面的证据:医疗保健的高优先级方面或特定的国家健康目标或优先事项;有意义的重点,例如导致预期的健康结果;以及护理方面的差距或差异。

设计

在美国病理学家学会 (CAP) 内部,措施和绩效评估小组委员会负责制定有用的绩效措施。然后,参与的从业者可以选择对他们各自的患者和实践有意义的措施,并反映他们提供的服务质量。

结果

CAP 制定了 23 项向医疗保险和医疗补助服务中心报告的质量措施,这些措施反映了严格的临床证据,并解决了需要改进绩效的领域。

结论

由于报告这些特定于病理学的指标的影响意义重大,因此以同行评审的方式呈现这些措施及其设计过程。本文描述的这些措施(第 1 部分)代表了 CAP 最近努力开发有意义的措施,这些措施反映了严格的临床证据,并强调了具有绩效改进机会的领域。

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