Fleegler B M, Wolk M, McCarville J
Management Engineering, Sarasota Memorial Hospital, USA.
J Fla Med Assoc. 1995 Mar;82(3):203-5.
The objective of this retrospective study was to evaluate the effectiveness of a peer review organization (PRO) on patient mortality rate in a not-for-profit, 988-bed community hospital in Florida. The number of deaths per hospital discharge (mortality) was compared prior to the Professional Foundation for Health Care (PFHC) holding the contract as the Medicare PRO (1983), during two years in which the PRO was fully active (1990 and 1991), during the year limited PRO activities were conducted (1992), and when PRO activities were again fully expanded (1993). All Medicare hospital discharges, including deaths, were included from January through May during 1983, 1990 through 1993. There was no intervention. Patient mortality as a determinant of PRO effectiveness was evaluated prior to the PRO, during a portion of the years the PFHC held the contract as the Medicare PRO, and an identical time period one year later with limited PRO review and again the following year when full reviews returned. The number of deaths did not change significantly. Mandated peer reviews of care to inpatient hospital Medicare beneficiaries did not significantly improve health care as measured by mortality.
这项回顾性研究的目的是评估同行评审组织（PRO）对佛罗里达州一家拥有988张床位的非营利性社区医院患者死亡率的影响。在专业医疗保健基金会（PFHC）作为医疗保险PRO（1983年）持有合同之前、PRO全面运作的两年（1990年和1991年）、PRO活动受限的一年（1992年）以及PRO活动再次全面扩展时（1993年），对每次医院出院的死亡人数（死亡率）进行了比较。纳入了1983年、1990年至1993年1月至5月期间所有医疗保险医院出院病例，包括死亡病例。未进行干预。在PRO成立之前、PFHC作为医疗保险PRO持有合同的部分年份期间、一年后PRO评审受限的相同时间段以及次年全面恢复评审时，对作为PRO有效性决定因素的患者死亡率进行了评估。死亡人数没有显著变化。对住院医疗保险受益人的护理进行强制同行评审，以死亡率衡量，并未显著改善医疗保健状况。
