Qualitätstransparenz in der stationären Krankenhausversorgung der Schweiz

Ahlen, Christine von; Moser, Dominik; Geißler, Alexander

doi:10.1055/a-1498-3528

Cited by 7 publications

(10 citation statements)

References 9 publications

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“…CH-IQI is based on the hospitals' accounting data, which is why it can be assumed that the data quality is high. Following quality initiatives in the United States, IQI was adapted for Germany, Austria, and Switzerland ( 9 ). The first evaluations in Switzerland were conducted in 2008/09.…”

Section: Methodsmentioning

confidence: 99%

Quality aspects relating to giving birth in Switzerland: An analysis of quality indicators in inpatient obstetrics from 2013 to 2017

Moser

2022

Front. Public Health

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Quality transparency supports the reduction of information asymmetries in the health care system and enables the targeted regulation of health care. This study examines quality variation in inpatient obstetric care using the official Federal Office of Public Health Inpatient Quality Indicators (CH-IQI; vaginal births with 3rd- and 4th-degree perineal tears, vaginal births with episiotomy, and Caesarean section for low-risk births). It includes 101 maternity hospitals and 425,810 births between 2013 and 2017. For births with perineal laceration of 3rd and 4th degree, Switzerland performs 0.9% poorer in comparison to Germany (D-IQI) and Austria (A-IQI). For births with episiotomy, Switzerland is 1.1% above Germany. The Caesarean section rate for low-risk births was 26.8% in Switzerland in 2017 (Germany: 25.9%). When comparing Swiss clinics, private clinic locations in particular stand out. One possible reason for this may be the density of care, patient demands or the system of affiliated physicians at these clinics.

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Section: Methodsmentioning

confidence: 99%

Quality aspects relating to giving birth in Switzerland: An analysis of quality indicators in inpatient obstetrics from 2013 to 2017

Moser

2022

Front. Public Health

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“…As a response the Swiss Health Insurance Act (KVG) has been adopted in 2021 and the associated expansion of Article 58 on quality development, quality orientation in the healthcare system will be signi cantly strengthened (2,3). A quality-oriented development has already been evident for several years in the area of healthcare planning, which is increasingly also based on quality criteria such as minimum volume regulations, certi cations, or the availability of specialised staff (4).…”

Section: Introductionmentioning

confidence: 99%

“…Apart from this, the quality initiatives to date are patchy and of limited informative value [4,5]. For example, the Federal O ce of Public Health (FOPH) has been publishing quality indicators for Swiss acute hospitals since 2008 (Swiss Inpatient Quality Indicators, CH-IQI) [6].…”

Section: Introductionmentioning

confidence: 99%

The Practicability of Swiss General Internal Medicine Quality Indicators in Hospital Inpatient Care

Ahlen

Moser

Schneider

et al. 2023

Preprint

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BACKGROUND: The quality transparency of medical care in Switzerland is underdeveloped in comparison to the range of healthcare services and utilisation of care. In order to strengthen the focus on quality, the Health Insurance Act (KVG) was revised and the Federal Quality Commission (EQK) was established. In the summer of 2021, the Swiss Society for General Internal Medicine (SGAIM) published six quality indicators for the inpatient sector, which support national efforts. The aim of these indicators is to facilitate a structured quality improvement process in internal medicine. There are currently no reference or comparative values for the SGAIM quality indicators. The present implementation study examines the practicability of the quality indicators recommended by the SGAIM in a hospital. It examines which quality indicators are helpful and supports the quality improvement cycle intended by the SGAIM. METHODS: Using the QUALIFY assessment tool for quality indicators, the SGAIM indicators are structurally evaluated using the example of Hospital Männedorf (Canton of Zurich). Within this framework, a retrospective data analysis of the years 2020 and 2021 was carried out with 5,376 internal medicine patients, internal medicine assistants and management physicians (32 in 2020; 34 in 2021) as well as the CIRS reporting circle of internal medicine. RESULTS: The examination of the methodological quality criteria for practicability according to the QUALIFY assessment instrument showed that many of the methodological quality criteria are fulfilled. However, the comprehensibility and interpretability for patients and the public are only given to a limited extent. The results of the SGAIM quality indicators in Hospital Männedorf were calculated according to the recommended evaluation intervals and were as such: A provisional discharge report within 24 hours was sent to the follow-up institution for an average of 23.7% of discharges. A new prescription of benzodiazepines in patients with an age of ≥65 years occurred in an average of 17.2% of patients per month. The fall history was collected from 100% of the patients. The monthly proportion of patients with transfusions with an Hb value of >8g/dl was 17.9% on average. The proportion of CIRS cases per patient averaged 1.3%. Hepatitis B vaccination protection was available to 100% of the staff in the medical service of internal medicine. Reference and comparative values for the classification of these results do not yet exist. CONCLUSIONS: The quality indicators recommended by the SGAIM for the transmission of provisional discharge reports, new prescriptions for benzodiazepines and transfusions with Hb values >8 g/dl proved helpful. Development potential was shown for the following quality indicators: CIRS case processing, biography of falls in the last 12 months and hepatitis B vaccination protection. In the sense of national quality development in accordance with the KVG, it is desirable that the specialist society further develops its quality indicators and contributes them to the national quality efforts, which are coordinated by the EQK.

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“…Damit erreicht die HSM-Versorgungsplanung eine Zentralisierung, die im Gegensatz zur kantonalen Krankenhausplanung weniger auf regionale Gegebenheiten Rücksicht nimmt [3]. Im Gegensatz zur innovativen leistungs-und qualitätsorientierten Planung ist die Verfügbarkeit von Schweizer Qualitätsinformationen (Qualitätstransparenz) im Vergleich zu anderen Ländern ausbaufähig [4,5]. Einige Qualitätsdaten und -analysen über die Behandlungsergebnisse der Spitäler sind zwar vorhanden, jedoch nur in ausgewählter Form der Öffentlichkeit zugänglich.…”

Section: Introductionunclassified

“…Im Gegensatz zur innovativen leistungs- und qualitätsorientierten Planung ist die Verfügbarkeit von Schweizer Qualitätsinformationen (Qualitätstransparenz) im Vergleich zu anderen Ländern ausbaufähig 4 5 . Einige Qualitätsdaten und -analysen über die Behandlungsergebnisse der Spitäler sind zwar vorhanden, jedoch nur in ausgewählter Form der Öffentlichkeit zugänglich.…”

Section: Introductionunclassified

Qualitätsvariation in der Schweiz: Analyse der Mamma-Resektionen bei Brustkrebs anhand des Qualitätsindikators der Brusterhaltung

2021

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Zusammenfassung Ziel der Studie Die Studie geht der Frage nach, ob in der Schweiz regionale Unterschiede bei den Behandlungsergebnissen von elektiven Mamma-Resektionen bei Brustkrebs bestehen und falls ja, ob eine mögliche Ursache in der Krankenhausplanung seitens der Kantone zu Grunde liegen könnte. Methodik Anhand der Inpatient Quality Indicators (CH-IQI) wird die Ergebnisqualität auf Ebene der Schweizer Kantone analysiert und mit den kantonalen Anforderungen, um diese Behandlung durchführen zu können, verglichen. Ergebnisse Kantonale Unterschiede wurden sowohl bei der Ergebnisqualität anhand des Qualitätsindikators der Brusterhaltung als auch bei dem Detaillierungsgrad der Anforderungen an die Struktur- und Prozessqualität deutlich. Schlussfolgerung Die Behandlungsqualität ist in der Schweiz kaum transparent vergleichbar; eine Interpretation der verfügbaren Qualitätsinformationen ist anspruchsvoll und für Patienten kaum möglich. Um die aufgezeigten Qualitätsunterschiede zu reduzieren, sollte die Krankenhausplanung interkantonal erfolgen, wie dies in der hochspezialisierten Medizin umgesetzt wird.

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Qualitätstransparenz in der stationären Krankenhausversorgung der Schweiz

Cited by 7 publications

References 9 publications

Quality aspects relating to giving birth in Switzerland: An analysis of quality indicators in inpatient obstetrics from 2013 to 2017

Quality aspects relating to giving birth in Switzerland: An analysis of quality indicators in inpatient obstetrics from 2013 to 2017

The Practicability of Swiss General Internal Medicine Quality Indicators in Hospital Inpatient Care

Qualitätsvariation in der Schweiz: Analyse der Mamma-Resektionen bei Brustkrebs anhand des Qualitätsindikators der Brusterhaltung

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