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医院价值医疗中心血管疾病和癌症的质量测量:文献系统评价。

Quality measurement for cardiovascular diseases and cancer in hospital value-based healthcare: a systematic review of the literature.

机构信息

Department of Health Services Research, CAPHRI, Maastricht University, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht, Limburg, The Netherlands.

Department of Hospitals Accreditation, Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI), Riyadh, Saudi Arabia.

出版信息

BMC Health Serv Res. 2022 Aug 1;22(1):979. doi: 10.1186/s12913-022-08347-x.

Abstract

BACKGROUND

This systematic literature review identifies hospital value-based healthcare quality measures, measurement practices, and tools, as well as potential strategies for improving cardiovascular diseases and cancer care.

METHODS

A systematic search was carried out in the PubMed, Embase, CINAHL, and MEDLINE (OvidSP) databases. We included studies on quality measures in hospital value-based healthcare for cardiovascular diseases and cancer. Two reviewers independently screened titles and abstracts, conducted a full-text review of potentially relevant articles, assessed the quality of included studies, and extracted data thematically. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and four validated tools were used for methodological quality assessment.

RESULTS

The search yielded 2860 publications. After screening the titles and abstracts, 60 articles were retrieved for full-text review. A total of 37 studies met our inclusion criteria. We found that standardized outcome sets with patient involvement were developed for some cardiovascular diseases and cancer. Despite the heterogeneity in outcome measures, there was consensus to include clinical outcomes on survival rate and disease control, disutility of care, and patient-reported outcome measures such as long-term quality of life.

CONCLUSION

Hospitals that developed value-based healthcare or are planning to do so can choose whether they prefer to implement the standardized outcomes step-by-step, collect additional measures, or develop their own set of measures. However, they need to ensure that their performance can be consistently compared to that of their peers and that they measure what prioritizes and maximizes value for their patients.

TRIAL REGISTRATION

PROSPERO ID: CRD42021229763 .

摘要

背景

本系统文献回顾确定了基于医院价值的医疗保健质量措施、测量实践和工具,以及改善心血管疾病和癌症护理的潜在策略。

方法

在 PubMed、Embase、CINAHL 和 MEDLINE(OvidSP)数据库中进行了系统搜索。我们纳入了关于基于医院价值的心血管疾病和癌症医疗保健质量措施的研究。两名审查员独立筛选标题和摘要,对可能相关的文章进行全文审查,评估纳入研究的质量,并进行主题数据提取。本综述按照系统评价和荟萃分析的首选报告项目进行,并使用了四个经过验证的工具进行方法学质量评估。

结果

搜索产生了 2860 篇出版物。经过筛选标题和摘要,有 60 篇文章进行了全文审查。共有 37 项研究符合纳入标准。我们发现,一些心血管疾病和癌症已经制定了具有患者参与的标准化结局集。尽管结局测量存在异质性,但已达成共识,包括生存率和疾病控制、护理不便以及患者报告的结局测量(如长期生活质量)等临床结局。

结论

已经开发或计划开发基于价值的医疗保健的医院可以选择是否逐步实施标准化结局,收集额外的措施,或开发自己的一套措施。然而,他们需要确保自己的绩效能够与同行进行一致比较,并衡量对患者最优先和最大化价值的措施。

试验注册

PROSPERO 注册号:CRD42021229763。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a26/9341062/3f315c1e7f69/12913_2022_8347_Fig1_HTML.jpg

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