O'Malley C
Am J Health Syst Pharm. 1997 Jul 1;54(13):1528-35. doi: 10.1093/ajhp/54.13.1528.
Efforts to measure the quality of care provided by health systems, including the accreditation processes used by the National Committee for Quality Assurance (NCQA) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and three report card systems-NCQA's Health Plan Employer Data and Information Set (HEDIS), JCAHO's requirements for performance data (Oryx), and a consumer-oriented system of performance measures created by the Foundation for Accountability (FACCT)-are described. NCQA reviews and accredits all types of health maintenance organizations, as well as point-of-service health plans and certain physician-hospital organizations. NCQA accreditation survey teams consist primarily of physicians. The fee for the process-oriented survey depends on the size and complexity of the plan. HEDIS was created to standardize the way in which health plans calculate and report information about their performance, thereby enabling comparisons among plans. NCQA is including more outcome measures as HEDIS is revised. Several HEDIS measures relate to medication use. In the future, health plans will be required to submit HEDIS data as part of the NCQA survey process. JCAHO's accreditation program for health care networks began in 1994. Survey teams and fees depend on the size and complexity of the network. A survey covers the central office, all hospitals, and selected components (excluding those that are accredited by other bodies recognized by JCAHO), and practitioners' offices. NCQA and JCAHO have no pharmacy-specific accreditation standards, but pharmacy information may be requested by the surveyors. In 1997 JCAHO began phasing in requirements for performance data as part of its accreditation process; networks must begin collecting data for at least 10 measures from five approved systems. FACCT performance measures are based on patients' health care experiences and outcomes; FACCT hopes these measures will be adopted by NCQA, JCAHO, and others. As health care purchasers and consumers increasingly demand evidence of quality, pharmacists will have ample opportunity to improve health outcomes.
文中描述了为衡量卫生系统所提供医疗服务质量而做出的努力，包括美国国家质量保证委员会（NCQA）和医疗组织认证联合委员会（JCAHO）所采用的认证程序，以及三种报告卡系统——NCQA的健康计划雇主数据与信息集（HEDIS）、JCAHO的绩效数据要求（奥瑞克斯），还有由责任基金会（FACCT）创建的面向消费者的绩效衡量系统。NCQA对各类健康维护组织、服务点健康计划以及某些医师 - 医院组织进行评审和认证。NCQA认证调查团队主要由医生组成。面向流程的调查费用取决于计划的规模和复杂性。HEDIS的创建是为了规范健康计划计算和报告其绩效信息的方式，从而实现不同计划之间的比较。随着HEDIS的修订，NCQA纳入了更多的结果指标。一些HEDIS指标与药物使用有关。未来，健康计划将被要求提交HEDIS数据作为NCQA调查过程的一部分。JCAHO针对医疗保健网络的认证计划始于1994年。调查团队和费用取决于网络的规模和复杂性。一次调查涵盖中心办公室、所有医院以及选定的组成部分（不包括那些由JCAHO认可的其他机构认证的部分）和从业者办公室。NCQA和JCAHO没有针对药房的特定认证标准，但调查人员可能会要求提供药房信息。1997年，JCAHO开始逐步将绩效数据要求纳入其认证过程；各网络必须开始从五个批准的系统中收集至少10项指标的数据。FACCT绩效指标基于患者的医疗保健经历和结果；FACCT希望这些指标能被NCQA、JCAHO及其他机构采用。随着医疗保健购买者和消费者对质量证据的需求日益增加，药剂师将有充分的机会改善医疗结果。
