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乌克兰基层医疗管理者对医疗保健质量的感知。

The perception of health care quality by primary health care managers in Ukraine.

机构信息

Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

Ukrainian-Swiss Project "Medical Education Development", Swiss Tropical and Public Health Institute, Kyiv, Ukraine.

出版信息

BMC Health Serv Res. 2022 Jul 10;22(1):895. doi: 10.1186/s12913-022-08300-y.

Abstract

BACKGROUND

Ukraine is reforming its health care system to improve quality of health care. Insight into how primary health care managers perceive quality is important for the ongoing reform as well as for the improvement of medical services.

METHODS

An online survey was conducted as part of the Ukrainian-Swiss project "Medical Educational Development" in April-May 2019 based on the contact list of USAID project "Health Reform Support", and additionally on the database of the National Health Service of Ukraine and other channels. Data were analyzed using descriptive statistics and qualitative data analysis.

RESULTS

In total, 302 health care managers took part in the study. The majority of primary health care managers perceive quality in health care as process quality. They associate quality mostly with compliance to standards. At the same time, primary health care managers prefer to assess outcome quality via a system of indicators and feedback. There appears to be a lack of consensus about health care quality. This may be due to a lack of awareness of the national strategy for better quality of health care service.

CONCLUSIONS

Our study provides new insights into primary care managers' perceptions of health care quality in Ukraine. The absence of a clear consensus about quality complicates the discussion about quality and how to measure quality in health care. This appears to be one of the obstacles to system-wide quality improvement.

摘要

背景

乌克兰正在改革其医疗体系,以提高医疗质量。了解基层医疗管理者对质量的看法对于正在进行的改革以及医疗服务的改善都很重要。

方法

作为乌克兰-瑞士项目“医疗教育发展”的一部分,于 2019 年 4 月至 5 月期间,基于美援署项目“卫生改革支持”的联系人名单,以及乌克兰国家卫生局数据库和其他渠道,进行了一项在线调查。采用描述性统计和定性数据分析方法对数据进行分析。

结果

共有 302 名医疗管理者参与了这项研究。大多数基层医疗管理者将医疗质量视为过程质量。他们将质量主要与遵守标准联系在一起。同时,基层医疗管理者更愿意通过指标和反馈系统来评估结果质量。对医疗质量似乎缺乏共识。这可能是由于对更好的医疗服务质量国家战略缺乏认识。

结论

本研究为了解乌克兰基层医疗管理者对医疗质量的看法提供了新的视角。对质量缺乏明确共识,使得关于质量的讨论以及如何衡量医疗质量变得复杂。这似乎是系统质量改进的障碍之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f333/9271244/fcc4c7bb09e9/12913_2022_8300_Fig1_HTML.jpg

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