Vorschläge der WHO zur umfassenden Leistungsbewertung von Krankenhäusern

Zusammenfassung

Zielsetzung: Ziel des Artikels ist es, einen Überblick über aktuelle Projekte zur Qualitätsmessung im Krankenhaus zu geben, auf die unterschiedlichen Dimensionen der Qualität in der Krankenhausversorgung hinzuweisen und Ansätze der WHO zur Leistungsbewertung von Krankenhäusern vorzustellen. Methodik: Es wurde eine Literaturübersicht zu Projekten zur Leistungsbewertung von Krankenhäusern durchgeführt und Projekte in ihren Kernkriterien dargestellt. Zwei aktuelle Projekte der WHO werden beschrieben und in Bezug auf den Einsatz von Standards und Indikatoren zur Messung der Versorgungsqualität im Krankenhaus diskutiert. Ergebnisse: Hinsichtlich der Konzeption eines Leistungsbewertungsmodells von Krankenhäusern besteht keinesfalls Konsens; vielmehr existieren viele unterschiedliche Modelle, die sich dahingehend unterscheiden, welche Qualitätsdimension erfasst werden, welche Methode zur Qualitätsmessung angewandt wird und wie die gewonnenen Informationen genutzt werden. Schlussfolgerung: Es besteht ein hoher Druck auf Krankenhäuser, transparenter zu werden und Leistungseinkäufern, Politikern und Bürgern Informationen darüber zu liefern, welche Leistungen in welcher Qualität erbracht werden. Unterschiedliche Zielgruppen benötigen unterschiedliche Informationen, und die Leistungsbewertung von Krankenhäusern sollte nicht nur auf rein klinische Ergebnisse limitiert sein, sondern auch wichtige Querschnittsthemen wie die Patienten-, Mitarbeiter- und Gemeindeorientierung berücksichtigen.

Abstract

Aim: It is the aim of the article to provide an overview on current indicator projects to measure hospital quality, to point at the different dimensions of quality in hospitals and to present approaches of WHO to assess hospital performance. Methods: A literature review on projects to assess hospital performance was carried out and projects are described in their core characteristics. Two current projects of WHO are described and discussed with regard to the use of standards and indicators to measure hospital performance. Results: Existing models to measure hospital performance differ concerning the quality dimensions considered, the methods used to assess quality and the use and application of information generated by performance measurement. Conclusion: There is great pressure on hospitals to become more transparent and to provide purchasers, politicians and citizens with information on the quality of care. Different stakeholders require different information and performance measurement should hence not be restricted on clinical effectiveness, but also embrace issues such as patient, staff and community orientation.

Schlüsselwörter

Krankenhaus - Qualitätsmanagement - Indikatoren - Standards - Leistungsbewertung - internationaler Überblick - WHO

Key words

Hospital - quality management - indicators - standards - performance measurement - international overview - WHO

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