基于评价指标的慢性心力衰竭治疗质量的趋势与变异

Trend and Variation of Treatment Quality of Chronic Heart Failure based on Evaluation Index

目的分析2011-2017年慢性心力衰竭(HF)治疗质量评价指标使用率变化趋势,计算HF治疗质量综合得分,获得综合质量变化趋势及变异,为提高HF治疗质量提供依据。方法选择HF治疗指南I类推荐的治疗质量评价指标12项,在单病种质量管理与控制平台中提取数据,计算HF评价指标使用率,基于分母权重法计算每年治疗质量综合得分及变异,并进行趋势性检验。结果与2011年相比,12项治疗质量指标中,左心室功能评价使用率增幅最大,健康教育使用率下降最大,趋势性检验有统计学意义。2011年至2017年间,医院综合得分中位数随时间增大(0.77~0.81),四分位数间距随时间有增加趋势。结论2011-2017年间,我国HF的多数治疗质量指标使用率有显著上升趋势,少数指标使用率下降,医院治疗质量综合得分升高,但医院间变异扩大,提示进一步提升HF治疗质量同时应关注医院间的质量差异。

Objective To analyze the trend of utilization rate of treatment quality evaluation indicator for chronic heart failure(HF)from 2011 to 2017,calculate the comprehensive treatment quality score of HF to obtain the variation trend and the variation ofcomprehensive quality,so as to provide evidence for improving the quality of HF treatment.Methods Twelve HF treatment quality evaluation indexes recommended by class I of HF treatment guidelines were selected to extract data from single-disease surveillance system;the utilization rate of HF evaluation index was calculated.the comprehensive score and variation of treatment quality were calculated based on the denominator weighting method,and the trend test was carried out.Results Compared with 2011,among the 12 treatment quality indicators,the use rate of left ventricular function evaluation increased the most,and the use rate of health education decreased the most.The trend test was statistically significant.From 2011 to 2017,the median of hospital comprehensive score increased with time,and the interquartile interval increased with time.Conclusion The utilization rate of most treatment quality indexes of HF in China has increased significantly;the hospital comprehensive score increased,but the variation between hospitals expanded.