Saywell R M, Bean J A, Ludke R L, Redman R W, McHugh G J
Health Serv Res. 1981 Fall;16(3):285-303.
To examine the relationships between measures of attending physician teams' clinical and utilization performance, inpatient hospital audits were conducted in 22 Maryland and western Pennsylvania nonfederal short-term hospitals. A total of 6,980 medical records were abstracted from eight diagnostic categories using the Payne and JCAH PEP medical audit procedures. The results indicate weak statistical associations between the two medical care evaluation audits; between clinical performance and utilization performance, as measured by appropriateness of admissions and length of stay; and between three utilization measures. Based on these findings, it does not appear valid to use performance in one area to evaluate performance in the other in order to measure or evaluate and ultimately improve physicians; clinical or utilization performance.
为了研究主治医师团队的临床指标与医疗服务利用绩效之间的关系，我们对马里兰州和宾夕法尼亚州西部的22家非联邦短期医院进行了住院患者医院审计。我们使用佩恩和联合委员会认证计划（JCAH PEP）医疗审计程序，从八个诊断类别中提取了总共6980份病历。结果表明，两项医疗评估审计之间、临床绩效与医疗服务利用绩效（以入院适宜性和住院时间衡量）之间以及三项医疗服务利用指标之间的统计关联较弱。基于这些发现，为了衡量、评估并最终改善医生的临床或医疗服务利用绩效，利用一个领域的绩效来评估另一个领域的绩效似乎并不合理。
