International journal for quality in health care : journal of the International Society for Quality in Health Care
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Int J Qual Health Care · Jun 2000
ReviewClinical indicators in accreditation: an effective stimulus to improve patient care.
The Australian Council on Healthcare Standards (ACHS) established the Care Evaluation Program (CEP) of clinical performance measures in its accreditation program to increase the clinical component of that program and to increase medical practitioner involvement in formal quality activities in their health care organizations. From the introduction of a set of generic indicators in 1993 the program expanded through all of the various medical disciplines and from January 2000 there will be 18 sets (well over 200 indicators) in the program. More than half of Australia's acute hospitals (covering the majority of patient separations) are monitoring the indicators and reporting clinical data twice yearly to the ACHS. ⋯ The program remains unique in the scope of the medical disciplines covered and in the formal provider involvement with indicator development. Both the clinical component of accreditation and clinician involvement in quality activities have been increased in an educational process. However, not all of the indicators are of equal value and a reduction in the number of indicators to a 'core' group of the most reliable and responsive ones is in process.
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Int J Qual Health Care · Oct 1999
Reliability study of the European appropriateness evaluation protocol.
To help to co-ordinate and harmonize research on utilization review in Europe, the US Appropriateness Evaluation Protocol (f¿EP) was adapted for use in the European setting. The aim of this paper is to assess the reliability of the European version of the AEP (EU-AEP). ⋯ The observed agreement could be considered substantial, especially if the fact that medical records were hand-written in a language native to only one of the reviewers is considered. Besides all the study limitations, this finding provides at least preliminary support for the application of the EU-AEP as a reliable instrument in the European setting, including application in comparative studies involving two or more countries.
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Int J Qual Health Care · Aug 1999
Meta AnalysisHow valid and reliable are patient satisfaction data? An analysis of 195 studies.
To assess the properties of validity and reliability of instruments used to assess satisfaction in a broad sample of health service user satisfaction studies, and to assess the level of awareness of these issues among study authors. ⋯ With few exceptions, the study instruments in this sample demonstrated little evidence of reliability or validity. Moreover, study authors exhibited a poor understanding of the importance of these properties in the assessment of satisfaction. Researchers must be aware that this is poor research practice, and that lack of a reliable and valid assessment instrument casts doubt on the credibility of satisfaction findings.
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Int J Qual Health Care · Aug 1999
Multicenter Study Comparative StudyOveruse and underuse of diagnostic upper gastrointestinal endoscopy in various clinical settings.
To describe and compare both overuse and underuse of diagnostic upper gastrointestinal endoscopy in different settings. ⋯ Rates of overuse and underuse depend mainly on case presentation and patient characteristics. Both over- and underuse should be addressed to maintain and improve quality of care.
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Int J Qual Health Care · Aug 1999
Multicenter StudyPatient satisfaction in Bangkok: the impact of hospital ownership and patient payment status.
Patient satisfaction with care received is an important dimension of evaluation that is examined only rarely in developing countries. Evidence about how satisfaction differs according to type of provider or patient payment status is extremely limited. ⋯ The survey confirms, to some extent, the stereotypes about quality of care in hospitals of different ownership. The results on payment status are intriguing but warrant further research.