美英澳中四国低风险死亡率指标及应用的比较研究  

Comparative Study on Low-risk Mortality as Quality Indicator and Application in United States,Britain,Australia and China

作　　者：王丹[1] 李壮 莫陶欣 薛冬[1] WANG Dan;LI Zhuang;MO Tao-xin;XUE Dong(Key laboratory of Carcinogenesis and Translational Research,Beijing Cancer Hospital)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所/恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《医院管理论坛》2021年第2期48-51,共4页Hospital Management Forum

摘　　要：目的比较美、英、澳、中四国在"低风险死亡率"方面的相关研究及应用,分析四国的管理经验,以期为我国完善低风险死亡率应用提供借鉴。方法利用文献综述法分析四国的相关研究文献,比较四个国家在指标发展历程、定义、研究类型、数据来源及样本量的异同。结果(1)四国对"低风险死亡率"的定义不同;(2)美、英两国重视"低风险死亡率"的理论研究,中国重视其应用研究,且应用范围更广;(3)美、英两国研究视角为不同类型卫生服务体系,选取样本容量较大;中国更多聚焦在单一三级医疗机构死亡病例,样本容量较少。结论"低风险死亡率"适合作为一种医疗质量筛查工具,单一使用不能有效反映规模较小医院的医疗安全和质量水平。中国在开展"低风险死亡率"应用研究的同时,应该同样重视开展"低风险死亡率"的理论研究,着眼于不同医疗卫生服务体系和人群,进一步验证、推广其在改进医疗服务质量中的应用。Objective To compare the relevant research and application of"low-risk mortality"in the United States,Britain,Australia,and China;To analyze the management experience of the four countries,in order to provide a reference for China to improve the application of low-risk mortality.Methods The literature review method was used to analyze the relevant researches of the four countries.The similarities and differences of the four countries in indicators,definitions,research types,data sources and sample sizes were compared.Results(1)The four countries have different definitions of"low-risk mortality";(2)The United States and the United Kingdom attached importance to the theoretical research of"low-risk mortality",while China attached importance to its applied research and had a wider range of applications;(3)The research perspective of the United Kingdom and the United States focused on different types of health service systems,with larger sample sizes.However,China focused more on deaths from a single tertiary medical institution with a smaller sample size.Conclusion"Low-risk mortality"is suitable as a medical quality screening tool.Single use of it cannot effectively reflect the medical safety and quality of small hospitals.While carrying out applied research on"low-risk mortality",China should also pay attention to carrying out theoretical research on"low-risk mortality",focusing on different health service systems and populations,and further verifying and promoting its role in improving the quality of medical services.

关 键 词：低风险死亡率 比较研究 医疗质量评价 

分 类 号：R197.5[医药卫生—卫生事业管理]