Bmc Health Serv Res
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Bmc Health Serv Res · Jan 2012
Evaluation of physicians' professional performance: an iterative development and validation study of multisource feedback instruments.
There is a global need to assess physicians' professional performance in actual clinical practice. Valid and reliable instruments are necessary to support these efforts. This study focuses on the reliability and validity, the influences of some sociodemographic biasing factors, associations between self and other evaluations, and the number of evaluations needed for reliable assessment of a physician based on the three instruments used for the multisource assessment of physicians' professional performance in the Netherlands. ⋯ The study demonstrated that the three MSF instruments produced reliable and valid data for evaluating physicians' professional performance in the Netherlands. Scores from peers, co-workers and patients were not correlated with self-evaluations. Future research should examine improvement of performance when using MSF.
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Bmc Health Serv Res · Jan 2012
Variation in cancer surgical outcomes associated with physician and nurse staffing: a retrospective observational study using the Japanese Diagnosis Procedure Combination Database.
Little is known about the effects of professional staffing on cancer surgical outcomes. The present study aimed to investigate the association between cancer surgical outcomes and physician/nurse staffing in relation to hospital volume. ⋯ Well-staffed hospitals confer a benefit for cancer surgical patients regarding reduced FTR, irrespective of hospital volume. These results suggest that consolidation of surgical centers linked with migration of medical professionals may improve the quality of cancer surgical management.
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Bmc Health Serv Res · Jan 2012
Mandatory quality reports in Germany from the hospitals' point of view: a cross-sectional observational study.
Public reporting of hospital quality is to enable providers, patients and the public to make comparisons regarding the quality of care and thus contribute to informed decisions. It stimulates quality improvement activities in hospitals and thus positively impacts treatment results. Hospitals often use publicly reported data for further internal or external purposes.As of 2005, German hospitals are obliged to publish structured quality reports (QR) every two years. This gives them the opportunity to demonstrate their performance by number, type and quality in a transparent way. However, it constitutes a major burden to hospitals to generate and publish data required, and it is yet unknown if hospitals feel adequately represented and at the same time consider the effort appropriate.This study assesses hospital leaders' judgement about the capability of QR to put legally defined aims effectively and efficiently into practice. It also explores the additional purposes hospitals use their QR for. ⋯ German hospitals consider the mandatory QR as only partially capable to put the legally defined aims effectively and efficiently into practice. In order for public reporting to achieve its potentially positive effects, the QR must be more closely aligned to the needs of hospitals.
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Bmc Health Serv Res · Jan 2012
Socio-economic inequalities in health care utilisation in Norway: a population based cross-sectional survey.
Norway provides universal health care coverage to all residents, but socio-economic inequalities in health are among the largest in Europe. Evidence on inequalities in health care utilisation is sparse, and the aim of this population based study was to investigate socio-economic inequalities in the utilisation of health care services in Tromsø, Norway. ⋯ This study revealed important inequalities in the utilisation of health care services in Norway, inequalities which may contribute to sustaining inequalities in health outcomes.
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Bmc Health Serv Res · Jan 2012
Integrated complex care coordination for children with medical complexity: a mixed-methods evaluation of tertiary care-community collaboration.
Primary care medical homes may improve health outcomes for children with special healthcare needs (CSHCN), by improving care coordination. However, community-based primary care practices may be challenged to deliver comprehensive care coordination to complex subsets of CSHCN such as children with medical complexity (CMC). Linking a tertiary care center with the community may achieve cost effective and high quality care for CMC. The objective of this study was to evaluate the outcomes of community-based complex care clinics integrated with a tertiary care center. ⋯ Complex care can be provided in community-based settings with less direct tertiary care involvement through an integrated clinic. Improvements in health care utilization and family-centeredness of care can be achieved despite minimal changes in parental perceptions of child health.