Novick L F, Dickinson K, Asnes R, Lan S M, Lowenstein R
Med Care. 1976 Jan;14(1):1-12. doi: 10.1097/00005650-197601000-00001.
Utilizing a tracer method in the assessment of care was investigated in a large pediatric clinic. A set of tracers were selected and agreement was obtained concerning the relevance of care criteria by at least 80 per cent of the facility physicians. One tracer, iron-deficiency anemia, was studied using two nonphysician abstractors to review a sample of 100 patient records with hemoglobins of 11.0 gm/100 ml or less. Results were compared with an implicit review by a panel of physicians. In 52 patients, the low hemoglobin level was not recognized. Only 25 patients proceeded through the care levels of evaluation, diagnosis, treatment, and follow-up. Poor compliance was found with the approved criteria. Weighted scores of the explicit tracer method were closely related to ratings by the implicit reviewers. Utilizing tracer assessment with nonphysician abstractors demonstrated remediable deficiencies in health care services.
在一家大型儿科诊所对使用追踪方法评估护理情况进行了调查。选择了一组追踪指标，并获得了至少80%的机构医生对护理标准相关性的认可。使用两名非医生摘要撰写人员对100份血红蛋白水平为11.0克/100毫升或更低的患者记录样本进行审查，对其中一个追踪指标——缺铁性贫血进行了研究。将结果与一组医生的隐性审查结果进行了比较。在52名患者中，低血红蛋白水平未被识别。只有25名患者完成了评估、诊断、治疗和随访等护理环节。发现对批准标准的依从性较差。显性追踪方法的加权分数与隐性审查人员的评分密切相关。使用非医生摘要撰写人员进行追踪评估表明，医疗服务中存在可补救的缺陷。
