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[Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden].
Z Evid Fortbild Qual Gesundhwes 2013; 107(8):541-7ZE

Abstract

BACKGROUND

Obligatory external quality assurance is an established method used to ensure the quality of inpatient care in Germany. The comprehensive approach is unique in international comparison. In addition to the statutory requirement, the health insurance funds require this form of external quality control in order to foster quality-based competition between hospitals. Ever since its introduction, healthcare providers have scrutinised the effects of the mandatory use of this survey.

METHOD AND MATERIALS

The study was based on all patients in the University Hospital Dresden, for whom a quality assurance sheet (n = 45,639) had to be recorded between 2003 and 2011. The documentation of these sheets was carried out by specially trained personnel. For each performance area, the duration of the documentation quality sheets was assessed, and a descriptive analysis of all quality assurance sheets was conducted. In the presence of statistical significance the so-called "Structured Dialogues" were analysed.

RESULTS

Over the whole period, 167 statistically noticeable problems occurred. Nine of these have been rated as noticeable problems in medical quality by the specialised working groups of the project office quality assurance (PGSQS) at the Saxon State Medical Association (SLÄK). The remaining 158 statistical anomalies included 25 documentation errors; 96 were classified as statistically significant, and only 37 were marked to indicate that re-observation by the PGSQS was required. The total effort estimate for the documentation of quality assurance sheets was approximately 1,420 working days in the observation period.

DISCUSSION

As far as the quality of patient care is concerned, the results can be considered positive because only a small number of quality indicators indicate noticeable qualitative problems. This statement is based primarily on the comparison of the groups of Saxony and Germany, which are included in the quality report of external quality assurance in accordance with sect. 137 SGB V. The majority of noticeable statistical problems were due to documentation errors. Other noticeable statistical problems that are medically indicated, but without effect on the extramural care to patients, recurrently occur with the respective quality indicators. Examples include the postoperative mobility indicators of the implementation of endoprostheses which cannot be used to draw conclusions about patient outcomes. Information on the quality of life as well as the post-hospital course of disease would be important in this context, but is still lacking. The use of external quality assurance data in accordance with sect. 137 SGB V for evaluation research has so far been handled quite restrictively. Thus, in-depth analyses on the quality of treatment cannot be derived.

Authors+Show Affiliations

Zentralbereich Qualitäts- und Medizinisches Risikomanagement, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden; Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden. Electronic address: Thomas.Petzold@uniklinikum-dresden.de.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Evaluation Studies
Journal Article

Language

ger

PubMed ID

24290668

Citation

Petzold, Thomas, et al. "[Evaluation of External Quality Assurance in Accordance With Sect. 137 SGB V at the Carl Gustav Carus University Hospital in Dresden]." Zeitschrift Fur Evidenz, Fortbildung Und Qualitat Im Gesundheitswesen, vol. 107, no. 8, 2013, pp. 541-7.
Petzold T, Steinwitz A, Schmitt J, et al. [Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden]. Z Evid Fortbild Qual Gesundhwes. 2013;107(8):541-7.
Petzold, T., Steinwitz, A., Schmitt, J., & Eberlein-Gonska, M. (2013). [Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden]. Zeitschrift Fur Evidenz, Fortbildung Und Qualitat Im Gesundheitswesen, 107(8), pp. 541-7. doi:10.1016/j.zefq.2013.08.011.
Petzold T, et al. [Evaluation of External Quality Assurance in Accordance With Sect. 137 SGB V at the Carl Gustav Carus University Hospital in Dresden]. Z Evid Fortbild Qual Gesundhwes. 2013;107(8):541-7. PubMed PMID: 24290668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden]. AU - Petzold,Thomas, AU - Steinwitz,Adrienne, AU - Schmitt,Jochen, AU - Eberlein-Gonska,Maria, Y1 - 2013/10/08/ PY - 2013/06/17/received PY - 2013/08/19/revised PY - 2013/08/29/accepted PY - 2013/12/3/entrez PY - 2013/12/3/pubmed PY - 2014/9/11/medline KW - Evaluation KW - Externe Qualitätssicherung KW - Nutzenbewertung KW - Quality assurance KW - benefit analysis KW - evaluation SP - 541 EP - 7 JF - Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen JO - Z Evid Fortbild Qual Gesundhwes VL - 107 IS - 8 N2 - BACKGROUND: Obligatory external quality assurance is an established method used to ensure the quality of inpatient care in Germany. The comprehensive approach is unique in international comparison. In addition to the statutory requirement, the health insurance funds require this form of external quality control in order to foster quality-based competition between hospitals. Ever since its introduction, healthcare providers have scrutinised the effects of the mandatory use of this survey. METHOD AND MATERIALS: The study was based on all patients in the University Hospital Dresden, for whom a quality assurance sheet (n = 45,639) had to be recorded between 2003 and 2011. The documentation of these sheets was carried out by specially trained personnel. For each performance area, the duration of the documentation quality sheets was assessed, and a descriptive analysis of all quality assurance sheets was conducted. In the presence of statistical significance the so-called "Structured Dialogues" were analysed. RESULTS: Over the whole period, 167 statistically noticeable problems occurred. Nine of these have been rated as noticeable problems in medical quality by the specialised working groups of the project office quality assurance (PGSQS) at the Saxon State Medical Association (SLÄK). The remaining 158 statistical anomalies included 25 documentation errors; 96 were classified as statistically significant, and only 37 were marked to indicate that re-observation by the PGSQS was required. The total effort estimate for the documentation of quality assurance sheets was approximately 1,420 working days in the observation period. DISCUSSION: As far as the quality of patient care is concerned, the results can be considered positive because only a small number of quality indicators indicate noticeable qualitative problems. This statement is based primarily on the comparison of the groups of Saxony and Germany, which are included in the quality report of external quality assurance in accordance with sect. 137 SGB V. The majority of noticeable statistical problems were due to documentation errors. Other noticeable statistical problems that are medically indicated, but without effect on the extramural care to patients, recurrently occur with the respective quality indicators. Examples include the postoperative mobility indicators of the implementation of endoprostheses which cannot be used to draw conclusions about patient outcomes. Information on the quality of life as well as the post-hospital course of disease would be important in this context, but is still lacking. The use of external quality assurance data in accordance with sect. 137 SGB V for evaluation research has so far been handled quite restrictively. Thus, in-depth analyses on the quality of treatment cannot be derived. SN - 2212-0289 UR - https://www.unboundmedicine.com/medline/citation/24290668/[Evaluation_of_external_quality_assurance_in_accordance_with_sect__137_SGB_V_at_the_Carl_Gustav_Carus_university_hospital_in_Dresden]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1865-9217(13)00196-7 DB - PRIME DP - Unbound Medicine ER -