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題名:澳洲臨床指標計畫及其對臺灣醫療品質指標之啟示
書刊名:醫務管理期刊
作者:莊秀文
作者(外文):Chuang, Sheu-wen
出版日期:2010
卷期:11:1
頁次:頁62-79
主題關鍵詞:臨床指標醫院評鑑臺灣醫療品質指標計畫臺灣醫療照護品質指標系列伽瑪卜瓦松混合模式Clinical indicatorHospital accreditationTQIPTHISGamma-poisson model
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(3) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:3
  • 共同引用共同引用:10
  • 點閱點閱:79
目的:國內現有的兩大全國性醫療品質指標;台灣醫療品質指標計畫(TQIP)與台灣醫療照護品質指標系列(THIS),至今推行已將近十年,對於醫療品質的改善也有顯著的貢獻,但是在分析模式、報告產出等指標應用上仍有不滿意之處。澳洲Australian Council on Healthcare Standard(ACHS)的臨床指標計畫,近年來不斷地在分析方法及報告內容與格式上修正與精進,大幅提升其醫療品質指標的實用效果。本文說明ACHS臨床指標計畫之指標分析方式與報告內容,引進國外成熟的技術與觀念,希望做爲國內醫療品質指標分析、報告、與運用的參考。方法:本文依據文獻探討與專家諮詢,完成ACHS臨床指標系統之資料釐清與發展過程的確認。結果:ACHS臨床指標計畫自1989年創始,其成長與發展的演化可分爲四個階段;指標開創期、指標成長期、分析方法精進期、輸入/出系統精進期,其中分析方法最重要的變革是採用二階層Gamma-Poisson混合模式與潛在獲益(gains)概念,並提供醫院一份綜合院內所有指標間比較的分析結果報告,主動提示醫院需要注意的指標,最有助於醫療品質的改善規劃與稽核。結論:依據THIS、TQIP與ACHS臨床指標計畫之比較差異,提出四點精進方式的具體改善建議,在指標分析與報告輸出內容上可以做爲台灣醫療品質指標系統發展的參考,進而能在下一個十年中,改善其分析、報告模式,充份運用國內長期通報的指標資料,提供給各個階層的使用者更有用、好用、有效的資訊,達到促成醫療品質持續改善的目的。
Objectives: Two national-level healthcare quality indicator programs (QIP) in Taiwan, the Taiwan Quality Indicator Project (TQIP) and the Taiwan Healthcare Indicator Series (THIS), have been implemented by many healthcare institutes over the last ten years. Although their contributions to quality improvement have been proven, the methods of statistical analysis and reporting indicators have not been satisfactory. The Australian Council on Healthcare Standards (ACHS) was the first in the world to introduce clinical indicators as part of the healthcare accreditation process. The method of analysis and reporting format for the ACHS clinical indicators program (CIP) have been refined in recent years. Applications of the refined program in practices produced a positive impact. This paper introduces ACHS CIP as a source of stimulation to improve Taiwan's quality indicators program in healthcare. Method: A literature review and consultation with experts were utilized to clarify the data and the evolutionary process. Results: The evolution of ACHS CIP occurred in four distinct developmental phases: the establishment of clinical indicators, the diversification of clinical indicators, the refinement of the method of analysis, and the redesign of input/output, from the inception of the program in 1989 to the present time. The most important changes in the method of analysis were to use the Gamma- Poisson hierarchical model and the concept of potential gains, and to provide a trend report for the integrated quality assessment. It is beneficial for hospitals to achieve the goal of continuous quality improvement. Conclusions: Four suggestions are made to the THIS and TQIP based on the ACHS CIP experience. It is hoped that this paper will stimulate a wider discussion of the enhancement in analysis and reporting methods for the Taiwan quality indicators programs. Within the next few years, refinement of the Taiwan QIP could be expected to produce useful, effective and easy to use information for continuous quality improvement.
期刊論文
1.吳肖琪、吳義勇、朱慧凡、林嘉彥、李鐘祥、張錦文、藍忠孚(20020400)。我國醫院醫療品質指標使用之情形。醫療品質,2(2),1-14。new window  延伸查詢new window
其他
1.財團法人醫院評鑑曁醫療品質策進會(2003)。醫療品質指標與應用。  延伸查詢new window
2.Chiu WT, Yang CM, Lin HW, Chu TB(2007)。Development and implementation on a nationwide health care quality indicator system in Taiwan。  new window
3.台灣醫務管理學會(2009)。台灣醫療照護品質指標系列簡介。  延伸查詢new window
4.董钰琪、楊銘欽、林奇霆、郭耕溢、朱子斌、邱文達(2006)。參加臺灣醫療照護品質指標系列(THIS) 之醫院實施現況及意見調査。  延伸查詢new window
5.Thomson R, Taber S, Lally J, Kazandjian V.(2004)。UK Quality Indicator Project(UK QIP) and UK independent health care sector: a new development。  new window
6.Williams SC, Schmaltz SP, Morton DJ, Koss RG, Loeb JM.(2005)。Quality of Care in U.S. Hospitals as Reflected by Standardized Measures。  new window
7.Collopy BT.(2000)。Clinical indicators in accreditation: an effective stimulus to improve patient care。  new window
8.Collopy BT, Williams J, Rodgers L, Campbell J, Jenner N, Andrews N.(2000)。The ACHS Care Evaluation Program: a decade of achievement。  new window
9.Gibberd R, Chuang S, Stark H.(2009)。Are clinical indicator results used or useful when accrediting Australian hospital?。  new window
10.Loeb JM.(2009)。Performance Measurement: The Good, The Bad, And The Ugly。  new window
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12.財團法人醫院評鑑暨醫療品質策進會(2009)。台灣醫療品質指標計畫。  延伸查詢new window
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15.The Australian Council on Healthcare Standards(1998)。Clinical Indicators in Summary。  new window
16.The Australian Council on Healthcare Standards(2008)。ACHS EQuIP 4。  new window
17.The Australian Council on Healthcare Standards(2007)。ACHS Clinical Indicator Users’ Manual 2007。  new window
18.Ebrahim JE, Cicuttini FM, Majoor JW, Mcneil JJ.(1999)。Acute Health Clinical In d ic a to r Project(Volume 2)。  new window
19.Gibberd RW, Pathmeswaran A, Burtenshaw K.(2000)。Using Clinical Indicators to Identify Areas For Quality Improvement。  new window
20.Howley PP, Gibberd RW.(2003)。Using hierarchical models to analyse clinical indicators: a comparison of the gamma-Poisson and beta-binomial models。  new window
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22.The Australian Council on Healthcare Standards(2008)。Australasian clinical indicator report 2001-2007 Determining Potential to Improve Quality of Care。  new window
23.The Australian Council on Healthcare Standards(2010)。Australasian Clinical Indicator Report: 2001-2008: Determining the Potential to Improve Quality of Care。  new window
 
 
 
 
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