Combs C Andrew, Kern-Goldberger Adina, Bauer Samuel T
Am J Obstet Gynecol. 2024 Mar;230(3):B2-B17. doi: 10.1016/j.ajog.2023.11.011. Epub 2023 Nov 7.
This article provides an updated overview and critique of clinical quality measures relevant to obstetrical care. The history of the quality movement in the United States and the proliferation of quality metrics over the past quarter-century are reviewed. Common uses of quality measures are summarized: payment programs, accreditation, public reporting, and quality improvement projects. We present listings of metrics that are reported by physicians or hospitals, either voluntarily or by mandate, to government agencies, payers, "watchdog" ratings organizations, and other entities. The costs and other burdens of extracting data and reporting metrics are summarized. The potential for unintended adverse consequences of the use of quality metrics is discussed along with approaches to mitigating adverse consequences. Finally, some recent attempts to develop simplified core measure sets are presented, with the promise that the complex and burdensome quality-metric enterprise may improve in the near future.
本文提供了与产科护理相关的临床质量指标的最新概述和评论。回顾了美国质量运动的历史以及过去四分之一世纪质量指标的激增情况。总结了质量指标的常见用途：支付计划、认证、公开报告和质量改进项目。我们列出了医生或医院自愿或按要求向政府机构、支付方、“监督”评级组织及其他实体报告的指标。总结了提取数据和报告指标的成本及其他负担。讨论了使用质量指标可能产生的意外不良后果以及减轻不良后果的方法。最后，介绍了一些近期开发简化核心指标集的尝试，有望在不久的将来改善复杂且繁重的质量指标体系。
