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Laryngorhinootologie 2001; 80(2): 101-108
DOI: 10.1055/s-2001-11852
VARIA
Georg Thieme Verlag Stuttgart ·New York

Messung der Ergebnisqualität als Ansatz zum Qualitätsmanagement in der Hals-Nasen-Ohrenheilkunde

 S. Maune1 ,  C. Schmidt2 ,  T. Küchler3
  • 1Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie (Direktor: Prof. Dr. H. Rudert)
  • 2Klinik für Allgemeine Chirurgie und Thoraxchirurgie (Direktor: Prof. Dr. B. Kremer)
  • 3Interdisziplinäres Referenzzentrum für Lebensqualität in der Onkologie (Leiter: Priv.-Doz. Dr. T. Küchler) der Christian-Albrechts-Universität zu Kiel
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Publication History

Publication Date:
31 December 2001 (online)

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Zusammenfassung

Hintergrund: In den letzten Jahren hat sich ein Paradigmenwechsel bei der Bewertung von medizinischen Behandlungsverfahren vollzogen. Der Begriff Lebensqualität (LQ) hat dabei insbesondere im Bereich onkologischer Erkrankungen eine zentrale Stellung erlangt und durch zahlreiche Studien in den letzten Jahren zu diesem Thema eine echte „Hausse” ausgelöst. Ein umfassendes Qualitätsmanagement könnte zum einen die immer knapper werdenden Ressourcen auffangen und zum anderen die notwendigen Optimierungen von Strukturen, Prozessen und Ergebnissen der Therapie erbringen. Insbesondere der neueste Gesetzentwurf des BMG „Gesundheitsreform 2000” unterstützt diesen Ansatz. Methode und Ergebnisse: Die Kombination von allgemeinem und spezifischem Lebensqualitäts-Fragebogen erlaubt eine Vergleichbarkeit beispielsweise onkologischer Daten zwischen einzelnen Tumorentitäten zum einen und liefert die zur Beurteilung der Ergebnisqualität wichtigen Ergebnisse der speziellen Behandlung zum anderen. Insbesondere im Bereich der Hals-Nasen-Ohrenheilkunde wurde in den letzten Jahren eine Reihe von Fragebogen für Karzinome im oberen Aerodigestivtrakt, Rhinosinusitis, Radiotherapie, saisonaler allergischer Rhinitis, Otitis media, Vertigo, Sprachstörungen und zur Evaluation operativer Eingriffe entwickelt. Schlussfolgerungen: Nach Ishikawa, dem Begründer des Total Quality Managements und der Qualitätszirkel, steht die Kundenorientierung im Mittelpunkt. Im Bereich der Medizin werden jedoch die Kunden, in diesem Fall Patienten, selten nach ihrer eigenen Bewertung der „Dienstleistung” Therapie befragt. Gerade jedoch durch die Parameter der Qualitätserfassung können kurz-, mittel- und langfristige Effekte einer Behandlung hinreichend genau erfasst werden. Hier kommt der LQ-Messung eine besondere Bedeutung zu, insbesondere wenn ökonomische Aspekte mit einbezogen werden.

Total Quality Management in Otorhinolaryngology: Quality of the Outcome

Background: The last years are characterized by a change of paradigms in the evaluation of medical therapeutical strategies. The term quality of life (QoL) has been established in oncology and could be demonstrated as a subject of highly qualified investigations which were published during the last years. An extendent quality management is correlated with the possibility of cost-effectiveness measurement and arrangement in a time characterized by decreasing financial resources of the hospitals and university departments. The experiences in the field of quality analysis could offer precious tools to optimize structures, processes and results of treatments. This aim is strongly supported by the expected law „Gesundheitsreform 2000”. Method and Results: Therefore reliable, valid tools are needed to calculate the effects of therapies. The combination of global and specific questionnaires include the possibility to compare oncologic data of different entities of malignomas. A couple of questionnaires in otorhinolaryngology were developed in the last decade involving the fields of malignomas of the upper aerodigestive tract, rhinosinusitis etc. Conclusions: Ishikawa, the founder of „Total Quality Management” and of the „Quality Circ”, pointed out the high importance of customer satisfaction. Whereas the patient is in the mid point of medical treatment there are hardly any investigations about customer satisfaction published. Therefore it is necessary to develop and establish validated tools for the measurement of quality dimensions. The short, middle and longlasting effects of a treatment could be calculated by quality of life measurements. The QoL is here of very strong importance, especially since economic aspects are included.

Schlüsselwörter:

Lebensqualität -Qualitätsmanagement - Onkologie

Key words:

Quality of life - Total quality management -Oncology

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Priv.-Doz. Dr. med. Steffen Maune

Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie
der Christian-Albrechts-Universität zu Kiel

Arnold-Heller-Straße 14
24105 Kiel


Email: E-mail: maune@hno.uni-kiel.de