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[患者调查在医疗质量保证中的潜力]

[The potentials of patient surveys for quality assurance in medical care].

作者信息

Mühr Cordula, Brunsmann Frank, Danner Martin

机构信息

Sozialverband Deutschland e. V., Berlin, Deutschland.

Allianz Chronischer Seltener Erkrankungen (ACHSE) e. V., Berlin, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2022 Mar;65(3):277-284. doi: 10.1007/s00103-022-03499-x. Epub 2022 Feb 9.

Abstract

What constitutes "quality" in medical care and the means by which it is controlled, secured, or (re-)established has largely been assigned to the joint self-administration of service providers and health insurers in Germany. The current implementation uses an understanding of quality that does not sufficiently take into account important patient-centered quality dimensions. One of the reasons for this might be that patient surveys are not yet recognized as an equivalent data source for quality assessment in the German healthcare context and are not yet established nationwide. Where patient survey instruments are used, they are often reduced to the survey of so-called patient satisfaction. In the future, survey instruments must be viewed and used in a much more differentiated manner.Indication-specific patient surveys on treatment results (patient-reported outcome measures; PROMs) can provide information on the success of treatment in certain diseases. With the targeted collection of patient experiences (patient-reported experience measures; PREMs), the process quality can also be determined. The routine use of corresponding patient surveys is provided according to §§ 136 ff. and § 299 Social Security Code Book V (SGB V) for the purposes of legally binding external quality assurance. Their use is intended to support the alignment of the health system towards value and benefit for patients. To this extent, there is an urgent need for implementation and considerable further development.

摘要

在德国,医疗服务中的“质量”构成要素以及控制、保障或(重新)建立质量的方式,很大程度上已交由服务提供者和健康保险公司共同自主管理。当前的实施方式所采用的质量理解,并未充分考虑到以患者为中心的重要质量维度。造成这种情况的原因之一可能是,在德国医疗环境中,患者调查尚未被视为质量评估的同等数据源,且尚未在全国范围内确立。在使用患者调查工具的地方,它们往往被简化为对所谓患者满意度的调查。未来,必须以更加差异化的方式看待和使用调查工具。针对特定适应症的治疗结果患者调查(患者报告结局测量;PROMs)可以提供某些疾病治疗成功情况的信息。通过有针对性地收集患者体验(患者报告体验测量;PREMs),还可以确定过程质量。根据《社会法典第五卷》(SGB V)第136条及以下条款和第299条,为具有法律约束力的外部质量保证目的,规定了相应患者调查的常规使用。其目的是支持卫生系统朝着为患者带来价值和益处的方向调整。就此而言,迫切需要实施并大力进一步发展。

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