Luft H S, Hunt S S
JAMA. 1986;255(20):2780-4.
Case abstract data are routinely collected by hospital abstracting services, peer review organizations, and some state agencies. These data have proved invaluable in the analysis of patterns of performance across large numbers of hospitals and have shown, for example, the inverse relation between diagnosis- or procedure-specific volume and outcome. Routinely collected data also appear to be an attractive means for identifying hospitals, and perhaps physicians, with particularly good or poor outcomes for their patients. Unfortunately, problems of small numbers of patients and relatively low rates of poor outcomes make it difficult to be confident in the identification of individual performers. Recent data for cardiac catheterization patients are used to illustrate this problem.
病例摘要数据通常由医院摘要服务机构、同行评审组织和一些州机构收集。这些数据在分析大量医院的绩效模式方面已被证明具有极高价值，例如，已显示出特定诊断或手术量与结果之间的反比关系。常规收集的数据似乎也是识别那些为患者带来特别好或特别差结果的医院，或许还有医生的一种有吸引力的手段。不幸的是，患者数量少以及不良结果发生率相对较低的问题使得难以确信能识别出个体表现者。用于心脏导管插入术患者的最新数据被用来说明这一问题。
