Sirio C A, Angus D C, Rosenthal G E
Department of Anesthesiology, University of Pittsburgh Medical Center, PA 15260.
New Horiz. 1994 Aug;2(3):321-5.
Cleveland Health Quality Choice (CHQC) is a unique community-based program designed to provide more efficient delivery of healthcare services through routine collection and dissemination of selected patient interventions and outcomes. This effort, coordinated by a consortium of business, hospital, and medical leaders, provides comparative public data on hospital performance. In the ICU, this effort involves collection of Acute Physiology and Chronic Health Evaluation (APACHE) III, as well as severity and prognostic data. To date, results suggest that a higher percentage of patients admitted to the ICU are at low risk of death or adverse outcome when compared with a national benchmark using APACHE III. Risk-adjusted mortality rates are lower and length of stay is shorter than predicted. CHQC demonstrates that cooperative public efforts, undertaken by groups with often divergent interests and using objective risk estimates, can provide useful data for hospital quality improvement activities and market-based health reform efforts.
克利夫兰健康质量选择（CHQC）是一个独特的基于社区的项目，旨在通过定期收集和传播选定的患者干预措施及结果，更高效地提供医疗服务。这项工作由商业、医院和医学领域的领导者组成的联盟协调，提供有关医院绩效的比较性公共数据。在重症监护病房（ICU），这项工作涉及收集急性生理学与慢性健康状况评估（APACHE）III以及严重程度和预后数据。迄今为止，结果表明，与使用APACHE III的全国基准相比，入住ICU的患者中低死亡风险或不良结局风险的比例更高。风险调整后的死亡率更低，住院时间也比预测的更短。CHQC表明，由利益往往不同的团体开展的合作性公共工作，并使用客观的风险评估，可以为医院质量改进活动和基于市场的医疗改革努力提供有用的数据。
