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[利用联邦医师协会的会计数据估算哨点医疗机构的分母]

[Estimating the denominator of a sentinel practice using accounting data of the federal physicians association].

作者信息

Schäfer T, Grüger J

机构信息

Dornier GmbH, Planungsberatung im Gesundheitswesen, Friedrichshafen.

出版信息

Gesundheitswesen. 1993 Feb;55(1 Suppl):26-31.

PMID:8467124
Abstract

In order to interpret the regional and temporal variation in the number of cases reported for sentinel topics, rates have to be calculated which relate these figures to a common denominator. For this denominator different definitions are possible, where this paper focuses on the contact denominator, counting all contacts between the patient and the doctor in a specified period of time and a specified population (i.e. children between 2 and 3 years of age by sex for the first MORBUS topic). One patient may produce different contacts. Due to work load considerations contact denominators could not be directly recorded in sentinel practices in the MORBUS-project. A method was developed which combined minimal denominator information obtained from sentinel practices with routine (accounting) data from the doctor's associations, in order to estimate denominators with a high degree of precision. Data elements in the accounting data base include number of personal patient-doctor-contacts by type of treatment (screening/cure/emergency/referral) and insurance status (ordinary member, family member, retired) itemized list of actions that were reimbursed through the insurance company structural data about the doctor/practice (specialty, accreditation date) etc. For a first assessment of the degree of accuracy with which denominators can be estimated by such data, a pilot test was scheduled for April 1991. Doctors recorded the number of contacts with children between two and three years of age (by sex) for one week on a simple checklist. A linear model which included specialty, region, number of vouchers per quarter, number of infant health assessments and date of accreditation as predictors, was fitted to the data.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为了解释哨点主题报告病例数的区域和时间变化,必须计算发病率,即将这些数字与一个共同的分母联系起来。对于这个分母,可以有不同的定义,本文重点关注接触分母,计算在特定时间段内特定人群(即第一个MORBUS主题中按性别划分的2至3岁儿童)中患者与医生之间的所有接触。一名患者可能会产生不同的接触。出于工作量的考虑,MORBUS项目的哨点医疗机构无法直接记录接触分母。开发了一种方法,将从哨点医疗机构获得的最小分母信息与医生协会的常规(会计)数据相结合,以便高精度地估计分母。会计数据库中的数据元素包括按治疗类型(筛查/治疗/急诊/转诊)和保险状况(普通会员、家庭成员、退休人员)列出的患者与医生个人接触的数量、通过保险公司报销的详细行动清单、关于医生/医疗机构的结构数据(专业、认证日期)等。为了初步评估通过这些数据估计分母的准确程度,计划于1991年4月进行一次试点测试。医生们在一份简单的清单上记录了一周内与2至3岁儿童(按性别)的接触次数。将专业、地区、每季度的凭证数量、婴儿健康评估次数和认证日期作为预测变量的线性模型应用于这些数据。(摘要截短于250字)

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