Burney R E, Jones K R, Coon J W, Blewitt D K, Herm A, Peterson M
Department of Surgery, University of Michigan, Ann Arbor 48109-0331, USA.
J Am Coll Surg. 1997 Dec;185(6):509-15. doi: 10.1016/s1072-7515(97)00108-7.
Demands on the medical profession to develop performance measures and demonstrate cost-effectiveness make it imperative that a uniform approach to the measurement of outcomes for common conditions be adopted. We report here on patient acceptance, response rates, and utility of a new set of core outcomes measures for patients with inguinal hernia (IH), which incorporates patient reporting of outcomes.
Beginning in March 1994, a convenience sample of patients scheduled for IH repair completed a series of questionnaires addressing a range of patient case mix and outcomes dimensions, including demographics, comorbid conditions, SF-36 health status (Medical Outcomes Study 36-item short-form health survey), and condition-specific questions, expectations, and responses to the surgical experience before and after operation. Surgical data were abstracted from the medical records.
One hundred three patients were entered in the study; 63 completed 2-month reports and 44 completed 6-month reports. Acceptance of the study and response rates were excellent. Differences in health status associated with IH have been identified in two SF-36 domains, and changes in function after repair noted in several others, supporting the applicability of this measure. Outcomes may also differ by type of hernia and type of repair performed.
A core outcomes measurement set for IH that encompasses demographics, comorbidities, health status, expectations, utilization, and condition-specific data provides a portrait of patient outcomes that is useful to providers and patients, and combined with cost and satisfaction data, it can be used for benchmarking and improving surgical care.
医学界面临着制定绩效指标并证明成本效益的要求，因此必须采用统一的方法来衡量常见病症的治疗结果。我们在此报告一套针对腹股沟疝（IH）患者的新的核心结局指标的患者接受度、回复率及效用，该指标纳入了患者对结局的报告。
从1994年3月开始，对计划进行腹股沟疝修补术的患者进行便利抽样，让他们完成一系列问卷，涉及一系列患者病例组合和结局维度，包括人口统计学、合并症、SF-36健康状况（医学结局研究36项简短健康调查）以及特定病情的问题、期望和对手术前后经历的反应。手术数据从病历中提取。
103名患者进入研究；63人完成了2个月的报告，44人完成了6个月的报告。研究的接受度和回复率都很高。在SF-36的两个领域中发现了与腹股沟疝相关的健康状况差异，在其他几个领域也注意到了修补术后功能的变化，这支持了该指标的适用性。结局也可能因疝的类型和所进行的修补类型而异。
一套针对腹股沟疝的核心结局指标，涵盖人口统计学、合并症、健康状况、期望、利用率和特定病情数据，为医疗服务提供者和患者提供了有用的患者结局描述，再结合成本和满意度数据，可用于基准测试和改善手术护理。
