Shroyer A L, London M J, VillaNueva C B, Sethi G K, Marshall G, Moritz T E, Henderson W G, McCarthy M J, Grover F L, Hammermeister K E
Department of Cardiac Research, Denver Veterans Affairs Medical Center, Colorado 80220, USA.
Med Care. 1995 Oct;33(10 Suppl):OS17-25. doi: 10.1097/00005650-199510001-00003.
Recently, a growing interest has arisen in defining and measuring health care outcomes. Although outcome measures may be used as potential quality-of-care screens, outcomes cannot indicate directly how care might be improved. Thus, the Processes, Structures, and Outcomes of Care in Cardiac Surgery (PSOCS) study was designed to investigate the linkages between the processes and structures of care with risk-adjusted outcomes for cardiac surgery care. Data are being collected on a comprehensive array of risk factors, processes, structures, and outcomes of care at 14 Veterans Affairs Medical Centers for this prospective, observational study. Approximately 6,000 cardiac surgery patients will be enrolled in this study over a 4.5-year period. Patient selection is based on a 6 workday rotating sampling frame with an oversampling of emergent patients. During the study, a register of all patients undergoing cardiac surgery at these centers is being maintained to assess the overall context of patient recruitment. The study will continue to enroll patients through December 1996. Major study end points extend beyond traditional measures of 30-day mortality and morbidity to encompass more innovative intermediate outcome measures, including changes in physical functional status and health-related quality of life.
最近，人们对界定和衡量医疗保健结果的兴趣日益浓厚。尽管结果指标可用作潜在的医疗质量筛选工具，但结果并不能直接表明如何改进医疗服务。因此，心脏外科护理的过程、结构与结果（PSOCS）研究旨在调查心脏外科护理的过程和结构与风险调整后的结果之间的联系。正在14家退伍军人事务医疗中心收集有关一系列全面的风险因素、护理过程、结构和结果的数据，用于这项前瞻性观察性研究。在4.5年的时间里，大约6000名心脏外科手术患者将被纳入该研究。患者选择基于一个6个工作日的轮换抽样框架，对急诊患者进行过度抽样。在研究期间，正在维护这些中心所有接受心脏外科手术患者的登记册，以评估患者招募的总体情况。该研究将持续招募患者至1996年12月。主要研究终点超出了30天死亡率和发病率的传统指标，涵盖了更具创新性的中间结果指标，包括身体功能状态的变化和与健康相关的生活质量。
