運用修正型德菲法與健保資料庫開發具可行性的兒科品質報告卡指標_

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題名：	運用修正型德菲法與健保資料庫開發具可行性的兒科品質報告卡指標
書刊名：	臺灣公共衛生雜誌
作者：	陳宗泰／鄒國英／徐世達／蔡宜蓉／許巍鐘／鍾國彪／黃莉茵
作者(外文)：	Chen, Tsung-tai／Tsou, Kuo-inn／Shyur, Shyh-dar／Tsai, I-jung／Hsu, Wei-chung／Chung, Kuo-piao／Huang, Li-ying
出版日期：	2017
卷期：	36:6
頁次：	頁613-622
主題關鍵詞：	兒科；品質指標；資訊公開；修正型德菲法；Pediatric；Quality measures；Open disclosure；Modified Delphi
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0) 排除自我引用:0 共同引用:3 點閱:4

目標：訂出適合我國國情並能與國外接軌的兒科品質報告卡指標。方法：參考國際組織與國外文獻發展的兒科指標，並邀請兒科及家醫科等相關的專家，以按照重要性、效度及改善機會等準則來萃取出專家偏好的指標，最後再陸續以不同的方法（如專家會議、修正型德菲法及健保資料庫輔助）來產生最終的代表性指標。結果：本研究選擇了4項兒科領域（3項疾病領域）：氣喘、積液性中耳炎、尿道感染及一般結果（例如死亡率）等，此4項領域共辨識出49項相關候選指標，最後選出7項兒科品質報告卡代表指標，包括氣喘4項，積液性中耳炎1項，以及尿道感染2項，這7項品質報告卡代表性指標的比率大部分呈現逐年惡化的品質趨勢。結論：本研究以修正型德菲法選出7項適合我國國情以及與國際接軌的指標，政府單位可參考本研究成果發展兒科品質報告卡來改善品質。

以文找文

Objectives: To develop pediatric indicators of public report card that are suitable for Taiwan's context and aligned with international standards. Methods: We referenced the pediatric indicators developed by international organizations and the literature and invited experts with specialties in pediatric and family medicine in order to extract their preferred indicators according to the selection criteria of importance, validity, and feasibility. The final results of the representative indicators were subsequently produced through different methods (i.e. professional meetings, modified Delphi, and aid from the National Health Insurance Administration (NHIA)'s claims database). Results: We chose four pediatric disease fields: asthma, otitis media with effusion (OME), urine tract infection (UTI), and general outcomes (e.g. mortality). We next identified a total of 49 candidate indicators from these 4 fields (3 disease categories) and then finally selected 7 representative indicators for the pediatric quality report card, including 4 asthma-related indicators, 1 OME indicator, and 2 UTI indicators. The adherence rates for most of these indicators demonstrated steadily deteriorating trends of quality. Conclusions: We employed the modified Delphi method to elicit 7 representative indicators that are suitable for our context and aligned with international standards. The government can utilize our study's results to develop a pediatric quality report card for improving quality of pediatric care.

以文找文

期刊論文
1.	Casalino, L. P.、Alexander, G. C.、Jin, L.、Konetzka, R. T.(2007)。General internists' views on pay-for-performance and public reporting of quality scores: a national survey。Health Aff.，26，492-499。
2.	Marshall, M. N.、Shekelle, P. G.、Leatherman, S.、Brook, R. H.(2000)。The public release of performance data: what do we expect to gain? A review of the evidence。The Journal of the American Medical Association，283(14)，1866-1874。
3.	Damberg, C. L.、Hyman, D.、France, J.(2014)。Do public reports of provider performance make their data and methods available and accessible?。Medical Care Research and Review，71，S81-S96。
4.	Jencks, S. F.、Cuerdon, T.、Burwen, D. R.(2000)。Quality of medical care delivered to Medicare beneficiaries: a profile at state and national levels。JAMA，284，1670-1676。
5.	Askari, M.、Wierenga, P. C.、Eslami, S.、Medlock, S.、de Rooij, S. E.、Abu-Hanna, A.(2011)。Assessing quality of care of elderly patients using the ACOVE quality indicator set: a systematic review。PLoS One，6，e28631。
6.	Rodriguez, H. P.、Perry, L.、Conrad, D. A.、Maynard, C.、Martin, D. P.、Grembowski, D. E.(2012)。The reliability of medical group performance measurement in a single insurer's pay for performance program。Med. Care，50，117-123。
7.	Diette, G. B.、Skinner, E. A.、Markson, L. E.(2001)。Consistency of care with national guidelines for children with asthma in managed care。J. Pediatr.，138，59-64。
8.	Hodgson, E. S.、Simpson, L.、Lannon, C. M.(2008)。Principles for the development and use of quality measures。Pediatrics，121，411-418。
9.	Chien, A. T.、Conti, R. M.、Pollack, H. A.(2007)。A pediatric-focused review of the performance incentive literature。Curr. Opin. Pediatr.，19，719-725。
10.	Mangione-Smith, R.、DeCristofaro, A. H.、Setodji, C. M.(2007)。The quality of ambulatory care delivered to children in the United States。N. Engl. J. Med.，357，1515-1523。
11.	Barry, E.、O'Brien, K.、Moriarty, F.(2016)。PIPc study: development of indicators of potentially inappropriate prescribing in children (PIPc) in primary care using a modified Delphi technique。BMJ Open，6，e012079。
12.	Sinaiko, A. D.、Eastman, D.、Rosenthal, M. B.(2012)。How report cards on physicians, physician groups, and hospitals can have greater impact on consumer choices。Health Affairs (Millwood)，31，602-611。
13.	Chen, T. T.、Chung, K. P.、Huang, H. C.、Man, L. N.、Lai, M. S.(2010)。Using discrete choice experiment to elicit doctors' preferences for the report card design of diabetes care in Taiwan--a pilot study。J. Eval. Clin. Pract.，16，14-20。
14.	McGlynn, E. A.(2003)。Selecting common measures of quality and system performance。Medical Care，41(1 SuppI)，I39-I47。
15.	Derose, S. F.、Asch, S. M.、Fielding, J. E.、Schuster, M. A.(2003)。Developing quality indicators for local health departments: experience in Los Angeles County。Am. J. Prev. Med.，25，347-357。
16.	Halladay, J. R.、Stearns, S. C.、Wroth, T.(2009)。Cost to primary care practices of responding to payer requests for quality and performance data。Ann. Fam. Med.，7，495-503。
17.	O'Brien, S. M.、Delong, E. R.、Peterson, E. D.(2008)。Impact of case volume on hospital performance assessment。Archives of Internal Medicine，168，1277-1284。
18.	Guttmann, A.、Razzaq, A.、Lindsay, P.、Zagorski, B.、Anderson, G. M.(2006)。Development of measures of the quality of emergency department care for children using a structured panel process。Pediatrics，118，114-123。
19.	Stang, A. S.、Straus, S. E.、Crotts, J.、Johnson, D. W.、Guttmann, A.(2013)。Quality indicators for high acuity pediatric conditions。Pediatrics，132，752-762。
20.	McFadden, E. R. Jr.、Hejal, R.(1995)。Asthma。Lancet，345，1215-1220。
21.	Rosenfeld, R. M.、Shin, J. J.、Schwartz, S. R.(2016)。Clinical practice guideline: otitis media with effusion executive summary (update)。Otolaryngol. Head Neck Surg.，154，201-214。
22.	Harrison, M. J.、Dusheiko, M.、Sutton, M.、Gravelle, H.、Doran, T.、Roland, M.(2014)。Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study。BMJ，349，g6423。
23.	Dimick, J. B.、Birkmeyer, J. D.(2008)。Ranking hospitals on surgical quality: does risk-adjustment always matter?。J. Am. Coll. Surg.，207，347-351。
24.	陳宗泰、鍾國彪、賴美淑(2007)。另一種流行趨勢--論成效計酬的趨勢與展望。臺灣公共衛生雜誌，26(5)，353-370。延伸查詢

研究報告
1.	陳宗泰、鄒國英、鍾國彪、劉越萍(2013)。兒科醫療照護之健保醫療品質指標研究 (計畫編號：DOH102-NH-9017)。台北：衛生福利部中央健康保險署。延伸查詢

圖書
1.	National Research Council、Institute of Medicine(2004)。Children's Health, The Nation's Wealth: Assessing and Improving Child Health。Washington, DC：Institute of Medicine。
2.	AHRQ(2006)。Pediatric Quality Indicators Overview。Rockville, MD：AHRQ。

其他
1.	Commonwealth Fund。Quality of health care for children and adolescents: a chartbook，http://www.commonwealthfund.org/~/media/files/publications/chartbook/2004/apr/quality-of-care-forchildren-and-adolescents--a-chartbook/leatherman_pedchartbook_700-pdf.pdf。
2.	Agency for Healthcare Research and Quality(2014)。National healthcare quality & disparities report，https://www.ahrq.gov/research/findings/nhqrdr/nhqdr14/index.html。
3.	American Medical Association。Physician consortium for performance improvement，http://physicianconsortium.org。
4.	National Committee for Quality Assurance。HEDIS 2015 physician measures--NCQA，https://www.ncqa.org/Portals/0/HEDISQM/Hedis2015/HEDIS%202015%20Physician%20Measures%20List.pdf。
5.	McGlynn, E. A.，Damberg, C. L.，Kerr, E. A.，Schuster, M. A.。Quality of care for children and adolescents: a review of the literature and quality indicators，http://www.rand.org/pubs/monograph_reports/MR1283。
6.	傅立葉，鄧宗業，黃東益，劉宜君，陳敦源，林國明。全民健保醫療品質資訊公開之社會效益評估，http://nccuir.lib.nccu.edu.tw/handle/140.119/42188。延伸查詢
7.	AHRQ(2013)。National guideline clearinghouse，https://www.guideline.gov/。

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