Medical care of ambulatory patients and its assessment: a review of international experience

Lukyantseva, D. V.; Сухоруких, О. А.; Omelyanovskiy, V. V.

doi:10.17749/2070-4909.2018.11.1.045-049

Cited by 4 publications

(1 citation statement)

References 2 publications

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“…Модель международного стандарта JCI (Joint Commission International) основана преимущественно на показателях, повышающих удовлетво-ренность пациентов условиями пребывания в МО [10,11]. Так, критерии качества клиники Мэйо основаны на принципе "нужды пациента превыше всего", которые ориентированы на комфортное пребывание пациента в МО и достигаются организацией командной работы персонала [3,[12][13][14]. Триада Донабедиана включает качество структуры, технологий и результата, объединяя медицинскую и организационную эффективность [15][16][17][18].…”

Section: Introductionunclassified

Quality balanced scorecard for the outpatient clinic

Latukha,

Son,

Bravve

et al. 2024

Cardiovasc Ther Prev

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The quality audit system for healthcare in various countries is based on the quality of medical services, the satisfaction of the patient and his relatives, as well as the quality of medical documentation. At the same time, quality indicators of healthcare facilities include criteria of the social and economic efficiency. Often these groups of indicators are considered by researchers separately from each other, and the literature available does not show balanced approaches to combining indicators from different groups within one process, which served as the basis for this work.Aim. The article is devoted to identifying the specifics of quality balanced scorecard for outpatient clinic using the example of the results of preventive examination for children in the first year of life.Material and methods. The study of quality indicators of the outpatient clinic was carried out from 2019 to 2023. The base of the study was the Clinical Consultative and Diagnostic Clinic № 27 in Novosibirsk. The study of the Clinic development was carried out from 2012 to 2023. The work used data from a social and expert survey of managers (20122018), as well as comparative modeling, general logical methods and techniques.Results. The longest multi-level and complex medical service is the process of preventive examination of children in the first year of life. Therefore, using his example, a quality balanced scorecard for the outpatient clinic was developed. At the first stage, medical quality criteria were determined. Patients were interviewed and quality criteria important for the patients' parents were determined. The complexity, multi-stage nature and short time frame for providing medical services determined the criteria for the economic efficiency. At the second stage, criteria for the management effectiveness and criteria for quality monitoring were developed, which allow department heads to track key performance indicators, as well as build coordinated work between various departments. At the third stage, the quality criteria were developed, which, on the one hand, reflect the clinic work, and, on the other hand, are not redundant and can be used to assess the effectiveness of the organization as a whole.Conclusion. The study showed that to increase the sustainability of the clinic development, effective monitoring based on key performance indicators is necessary. The classical approach to determining the effectiveness of medical facilities is based on general performance indicators to the quality criteria of individual processes, which does not allow identifying violations in individual medical and auxiliary processes, and, accordingly, does not allow identifying ways to solve them. It also does not indicate the level of violation. The use of a process and system approach in developing quality criteria allows developing a quality balanced scorecard with respect to the criteria of various groups, which ultimately reflects the effectiveness of processes as a whole, provides an understanding of cause-and-effect relationships and identifies the root cause of destabilization.

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Section: Introductionunclassified

Quality balanced scorecard for the outpatient clinic

Latukha,

Son,

Bravve

et al. 2024

Cardiovasc Ther Prev

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Regional Experience in Improving the Quality and Cost-Effectiveness of Medical Care for Children with Acute Respiratory Pathology in the Rostov Region

et al. 2023

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One of the priorities of the modern world medical community is the continuous comprehensive improvement of medical care quality. Evaluation of medical care quality and material costs level for the management of patients with acute respiratory pathology (ARP) was performed in one city medical facility, as well as cost-effectiveness analysis of the project “Improvement of medical care quality for children of the Rostov region”. The first step of this study was retrospective audit of source medical records (n = 154) of Children’s hospital via the adapted World Health Organization questionnaire “Evaluation of in-patient care quality for children” recommended for Europe and revised in 2015. Inclusion criteria: hospitalization of patients with acute conditions; outcome — recovery with no complications; presence of one of the clinical manifestations (acute nasopharyngitis, acute non-obstructive bronchitis, acute obstructive bronchitis, acute obstructive laryngitis, acute community-acquired pneumonia). The cost-effectiveness evaluation was performed considering the direct treatment costs and the coefficient of economic costs per patient (CECPP). Analysis of the study’s first stage has revealed defects in medical care quality, significant and irrational material costs of the medical facility at all stages of medical and diagnostic care for children with ARP. CECPP peak indicators came under notice in all observation groups due to high expenses on medications and specifically those not included in clinical practice guidelines, vast amount of unreasonable hospitalizations and diagnostic procedures, expenses on physical therapy (PT), etc. Analysis of the study’s second stage medical records (n = 146) of patients with ARP took place after the initial audit followed by quarterly monitoring and hospital staff training (endpoint — 12 months). Significant improvements in the health care quality and cost-effectiveness for children with ARP have been shown.

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Developing clinical guidelines and assessing the quality of medical care using the RAND/UCLA method

2020

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Фармакоэкономические аспекты применения ингибиторов циклинзависимых киназ 4 и 6 в первой линии терапии местнораспространенного или метастатического рака молочной железы Оптимизация лекарственного обеспечения пациентов со злокачественными новообразованиями на уровне субъекта Российской Федерации Оценка технологий здравоохранения в Австралии Том 12 2019 FARMAKOEKONOMIKA Modern

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Medical care of ambulatory patients and its assessment: a review of international experience

Cited by 4 publications

References 2 publications

Quality balanced scorecard for the outpatient clinic

Quality balanced scorecard for the outpatient clinic

Regional Experience in Improving the Quality and Cost-Effectiveness of Medical Care for Children with Acute Respiratory Pathology in the Rostov Region

Developing clinical guidelines and assessing the quality of medical care using the RAND/UCLA method

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