美国医院质量评价体系及评价方法

介绍美国目前采用的四个医院质量评价体系,即美国年度最佳医院评价体系、美国百佳医院评价体系、国际医疗质量评价体系和医疗机构评审联合委员会评价体系。其中最佳医院评价体系是由基础建设指标、过程指标、结果指标三部分组成,先按专科领域进行排名,然后采用加权指数法计算医院质量指数,再根据医院专科排名和数量产生最佳医院。百佳医院评价体系是在同规模医院范围内,根据医院质量与安全指标评出百佳医院,评价指标包括风险调整死亡率指数、并发症指数、病情严重度调整平均住院日等8项。国际医疗质量和医疗机构评审联合委员会评价体系也在多个国家应用,用于评定临床医疗效率,在医疗质量临测和促进方面,享有较高的信誉。

Methodologies for evaluating hospital quality in America

The paper gives an account of the four systems that are currently used for evaluating hospital quality in America, viz. America's Best Hospitals, Solucient 100 Top Hospitals, International Quality Indicator Project, and the Joint Commission on Accreditation of Healthcare Organizations. The "America's Best Hospitals" methodology takes into account three factors, infrastructure, process and outcome. Hospitals are first ranked in specialties, then the index of hospital quality is calculated by means of weighted indexes, and after that the best hospitals are selected according to the specialty rankings and the number of the hospitals. The "Solucient 100 Top Hospitals" methodology selects 100 top hospitals among hospitals of the same size on the basis of hospital quality and safety indexes. The evaluation indexes include eight items, such as index of risk-adjusted mortality rates, index of complications, and disease severity-adjusted average length of hospital stay. The methodologies of "International Quality Indicator Project" and "the Joint Commission on Accreditation of Healthcare Organizations" are used in many countries to evaluate clinical efficiency and enjoy high reputation in monitoring and promoting medical quality.