Barnes P W, Arpante N M, Lewis V C, Rosenfield A
Columbia School of Public Health, New York, New York 10032, USA.
West J Med. 1995 Sep;163(3 Suppl):28-32.
Standards of care for all medical services are designed by and for professionals and generally follow medical professional society guidelines. Most managed care organizations rely on professional medical standards of practice, which provide broad guidelines to providers. Family planning agencies, on the other hand, generally follow Title X program guidelines, which provide specific standards of care. The Title X guidelines include detailed instructions about service delivery and program content. The differences between these two sets of standards result in a wide variation in practice guidelines across the spectrum of health care providers. From the patient perspective, evaluation of care is generally not related to professional standards, but instead focuses on quality measures related to access and interpersonal aspects of care. The member satisfaction surveys developed by some managed care organizations now have a large enough sample size to provide meaningful measures of patient satisfaction at the individual provider level. A uniform set of practice guidelines is needed for family planning services that incorporates the strengths of all three approaches and that link performance to generally accepted practice guidelines.
所有医疗服务的护理标准由专业人员制定并为其所用，通常遵循医学专业协会的指导方针。大多数管理式医疗组织依赖专业医疗实践标准，这些标准为提供者提供广泛的指导方针。另一方面，计划生育机构通常遵循《第十章》计划的指导方针，该方针提供具体的护理标准。《第十章》指导方针包括有关服务提供和计划内容的详细说明。这两套标准之间的差异导致各类医疗服务提供者的实践指南存在很大差异。从患者的角度来看，对护理的评估通常与专业标准无关，而是侧重于与护理的可及性和人际方面相关的质量指标。一些管理式医疗组织开展的会员满意度调查现在有足够大的样本量，能够在个体提供者层面提供有意义的患者满意度衡量指标。计划生育服务需要一套统一的实践指南，该指南应融合所有三种方法的优势，并将绩效与普遍接受的实践指南联系起来。
