Coûts de la qualité et de la non qualité des soins dans les établissements de santé état des lieux et propositions - Couts qualite2 2004 Rap

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156

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Posted on Jul 01 2004 Élaboré conjointement avec le Comité de Coordination de l’Evaluation Clinique et de la Qualité en Aquitaine, ce rapport s'inscrit dans la continuité du précédent rapport de 1998 sur ce thème. Afin de sensibiliser les professionnels des établissements de santé à la dimension économique de la qualité, il fournit une synthèse des travaux français et internationaux sur le coût de la qualité et de la non-qualité des soins en 2004, propose des pistes de recherche et de réflexion sur ces thématiques et développe des outils opérationnels de mesure du coût moyen de la qualité dans quatre domaines : infections à bactéries multirésistantes, antibioprophylaxie inadaptée, escarres, radiographies inadaptées. Posted on Jul 01 2004
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Publié le

01 juillet 2004

Nombre de lectures

17

Licence :

En savoir +

Paternité, pas d'utilisation commerciale, partage des conditions initiales à l'identique

Langue

Français

Poids de l'ouvrage

2 Mo

LES COÛTS DE LA QUALITÉ ET DE LA NON-QUALITÉ DES SOINS DANS LES ÉTABLISSEMENTS DE SANTÉ:
ÉTATS DES LIEUX ET PROPOSITIONS
  
 
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IT JZ@RCHGTTTTTc_TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT IIT !G MC^@ HGD HZ]6F@D HG NF6!I@Z HGD DCI?D8MC^@ HG !6 ?C?0NF6!I@Z= TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTca LL= +=U% 60`' 3%2 :;:7%(%7'2 473:24*5)"%2 ===========================================================================================================SZ
LL=I= U% 60`' 3%2 21* 1'4"425'4072 3% *%2201*6%2 =======================================================================================================KJ IIIT !2IJA6M@ JZHIMC0ZMC?CJINFG H2I?@GB>G?@IC?D HG ABZ>G?@IC? HGD HZ]6F@D HG NF6!I@Z HGD DCI?DTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTde LLL=+= U%2 6g%(472 6"474?1%2 =====================================================================================================================================K+
LLL=I= U%2 &*0>*5((%2 3c5(:"40*5'407 607'471% 3% "5 ?15"4': ==================================================================================KI
LLL=S= U%2 47'%*;%7'4072 3% &*:;%7'407 3%2 47@%6'4072 702060(45"%2 %' 3c56643%7'2 3c%D&024'407 51 257>================KS
LLL=K= U5 (42% %7 &"56% 3% &%*2077%" 21&&":(%7'54*% ===============================================================================================KK
LLL=Y= U%2 47'%*;%7'4072 3% *5'4075"425'407 3%2 3:&%72%2===========================================================================================KY I>T !G !IG? G?@BG MC^@D G@ BZDF!@6@D H2I?HIM6@GFBD HG NF6!I@Z HGD DCI?DT TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTd_ !GD HC??ZGD ]B6?f6IDGD DFB !G MC^@ HG !6 NF6!I@ZTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTgTTdTTTTTTTTT IT !G MC^@ HGD HZ]6F@D HG NF6!I@Z HGD DCI?D8HG !6 ?C?0NF6!I@Z= TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTdg L=+= U%2 :;:7%(%7'2 473:24*5)"%2 ===========================================================================================================================K-
L=I=
L=S=
IIT 
LL=+=
LL=I=
LL=S=
LL=K=
Uc1'4"425'407 4753:?15'% 3%2 *%2201*6%2===========================================================================================================YS
U%2 3:@51'2 31 64*614' 31 (:3465(%7'=============================================================================================================YZ
!2HGD I?@GB>G?@IC?D HG ABZ>G?@IC? HGD HZ]6F@D HG NF6!I@Z HG DCI?DIJA6M@ TTTT_eTTTTTTTTTTTTTTTTTTTTTTTTTTT 
U%2 &*0>*5((%2 3c5(5"40*5'407 607'471% 3% "5 ?15"4': ==================================================================================^J
U%2 47'%*;%7'4072 3% &*:;%7'407 3%2 *42?1%2====================================================================================================^+
U%2 47'%*;%7'4072 3% *5'4075"425'407 3%2 3:&%72%2===========================================================================================^I
U% 3:;%"0&&%(%7' 3% "5 6g4*1*>4% 5()1"5'04*% ===============================================================================================^S
CCWCaA R A75%2 b 2%*;46% :;5"15'407 :6070(4?1% b F14""%' IJJK R Z R
U%2 60`'2 3% "5 ?15"4': %' 3% "5 707R?15"4': 3%2 20472 3572 "%2 :'5)"422%(%7'2 3% 257': P :'5' 3%2 "4%1D %' &*0&024'4072
\I!6? G@ AGBDAGM@I>GDTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTYT_TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT IT @G?@6@I>GD H2GW@B6AC!6@IC?D h A6B@IB HGD HC??ZGD HG MC^@ HIDAC?I\!GD G? ]B6?MGTTTTTTTTTTTTTTTTT_Y L=+= C076%*757' "%2 :;:7%(%7'2 473:24*5)"%2 (:3465(%7'%1D===============================================================================^Y
L=I= C076%*757' "%2 47@%6'4072 702060(45"%2 =========================================================================================================^^
IIT !GD \GDCI?D G? I?]CBJ6@IC?TTTTTTa_TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT 
LL=+= U%2 )%20472 %7 47@0*(5'407 6076%*757' "% 60`' 3%2 3:@51'2 3% ?15"4': %7 :'5)"422%(%7' 3% 257':===================^Z
LL=I= U%2 )%20472 %7 47@0*(5'407 6076%*757' "%2 60`'2 3c47;%2'422%(%7' 3572 "5 ?15"4': %7 :'5)"422%(%7' 3% 257': ===========================================================================================================================================================^, IIIT !GD AID@GD HG BGMRGBMRGTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTU_TTTTTTTTT ]IMRGD CF@I!DTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTaTTTXTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT IT M6!MF! HG !6 ]BZNFG?MG HGD HZ]6F@D HG NF6!I@Z HG DCI?DTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTaTTTTTTTTTTTc 
L=+=
L=I=
IIT 
LL=+=
s;:7%(%7'2 473:24*5)"%2 =================================================================================================================================ZS
n'4"425'4072 4753:?15'%2 3%2 *%2201*6%2 N21* 1'4"425'4072 01 2012R1'4"425'4072O================================================ZK
MMC^@ JCQG? HF HZ]6F@ HG NF6!I@Z HGD DCI?D6!MF! HF TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTaTYTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT 
s;:7%(%7'2 473:24*5)"%2 =================================================================================================================================ZY
LL=I= n'4"425'4072 4753:?15'%2 3%2 *%2201*6%2 N21* %' 2012R1'4"425'407O=====================================================================ZY IIIT MC^@ HGD JGDFBGD HG ABZ>G?@IC? HGD HZ]6F@D HG NF6!I@Z HGD DCI?DTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTYaTTTTTTTTTTTT 6??GWGXT BGMRGBMRG HCMFJG?@6IBGTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTXTTTTTea 6??GWGbT BG>FG HG !6 !I@@ZB6@FBGeUTTTXTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT IT DZ!GM@IC? HGD 6B@IM!GDTTTTTTTTTTTTTTTTTTTTTTTTTTTTUeXTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT 
L=+= C*4'G*%2 3% 2:"%6'407========================================================================================================================================+J,
L=I= r:21"'5'2 3% "5 2:"%6'407 3c5*'46"%2 ==================================================================================================================+J, IIT !G MCF@ HGD HZ]6F@D HG NF6!I@Z HGD DCI?DTTTTTTTTTTTTTTTTeXXTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT LL=+= U% 60`' 3%2 :;:7%(%7'2 473:24*5)"%2 NWLO=======================================================================================================++J
LL=I= U%2 21* 1'4"425'4072 3% *%2201*6%2 ====================================================================================================================+IY IIIT !2IJA6M@ JZHIMC0ZMC?CJINFG H2I?@GB>G?@IC?D HG ABZ>G?@IC? HGD HZ]6F@D HG NF6!I@Z HGD DCI?DTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTbaTXTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT LLL=+= L(&56' (:3460R:6070(4?1% 3%2 6g%(472 6"474?1%2 ========================================================================================+I-
LLL=I= L(&56' 3% &*0>*5((%2 3c5(:"40*5'407 607'471% 3% "5 ?15"4': ========================================================================+S-
LLL=S= L(&56' (:3460R:6070(4?1% 3%2 47'%*;%7'4072 3% &*:;%7'407 3%2 47@%6'4072 702060(45"%2 01 3c56643%7'2 3c%D&024'407 51 257> =======================================================================================================================================+S,
LLL=K= L(&56' 3% "5 (42% %7 &"56% 3% &%*2077%" 21&&":(%7'54*%================================================================================+K+
LLL=Y= L(&56' (:3460R:6070(4?1% 3%2 47'%*;%7'4072 3% *5'4075"425'407 3%2 3:&%72%2==============================================+KS I>T ! BZDF!@6@D HG !IG? G?@BG MC^@ G@2I?HIM6@GFBD HG NF6!I@Z HGD DCI?DTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTXTdYTTTTTTTTTTTT BZBZ]MGG?DTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTUdXTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT 
  
CCWCaA R A75%2 b 2%*;46% :;5"15'407 :6070(4?1% b F14""%' IJJK R -R
U%2 60`'2 3% "5 ?15"4': %' 3% "5 707R?15"4': 3%2 20472 3572 "%2 :'5)"422%(%7'2 3% 257': P :'5' 3%2 "4%1D %' &*0&024'4072
DQ?@RSDG 
!G MC?@GW@G G@ !GD G?`GFW  Uc:;0"1'407 31 607'%D'% :6070(4?1% %' @475764%* N566:":*5'407 3% "5 &*%22407 )13>:'54*% &%257' 21* "%2 :'5)"422%(%7'2 3% 257':8 (42% %7 &"56% 3% "5 '5*4@465'407 E "c56'4;4':8 ?1%2'407 201"%;:% 3% "5 *:>1"5'407 &5* "5 ?15"4':O8 20645" N&"12 @0*'% &*%22407 3%2 &5'4%7'2 &01* "5 ?15"4': %' "5 2:61*4':8 (42% %7 60761**%76% 3%2 :'5)"422%(%7'2O %' *:>"%(%7'54*% N566*:34'5'4078 3:;%"0&&%(%7' 3% "c:;5"15'407 3%2 &*5'4?1%2 &*0@%224077%""%2O 3%2 :'5)"422%(%7'2 3% 257': @54' 31 60`' 3% "5 ?15"4': 17% ?1%2'407 3c56'15"4':= U% &*:2%7' *5&&0*' 5 :': 474'4: E "5 3%(573% 31 34*%6'%1* >:7:*5" 3% "cA75%2 ?14 5 201g54': 56'15"42%* 17 &*%(4%* *5&&0*' :"5)0*: %7 +,,- N"% 60`' 3% "5 ?15"4': %' 3% "5 707R?15"4': E "cgh&4'5"O8 &01* "%2 *542072 214;57'%2 P R 3% 701;%""%2 60775422576%2 21* 6% 'gG(% 207' 342&074)"%2 i R "% &*%(4%* 3061(%7' 5<57' &02: "%2 )52%2 'g:0*4?1%28 4" *%2'54' E &*0&02%* 3%2 01'4"2 &*5>(5'4?1%2 3% (42% %7 H1;*% i R "%2 &*0@%224077%"2 3% 257': 7c07' &52 60(&"G'%(%7' 5&&*4;042: "5 34(%72407 :6070(4?1% 3% "5 ?15"4':8 ?14 %2' '*0& 201;%7' &%*B1% 60((% 17% 201*6% 2<2':(5'4?1% 3% 21*60`'=  C% *5&&0*' 2c53*%22% 51D &*0@%224077%"2 3%2 :'5)"422%(%7'2 3% 257': %D%*B57' 3%2 @076'4072 3c%7653*%(%7' %' 51D 472'576%2 3:6424077%""%2 @*57B542%2= $%2 0)F%6'4@2 207' 3% 2%724)4"42%* "%2 &*0@%224077%"2 3%2 :'5)"422%(%7'2 3% 257': E "5 34(%72407 :6070(4?1% 3% "5 ?15"4':8 3% @01*74* 3%2 47@0*(5'4072 21* "% 60`' 3% "5 ?15"4': %' 3% "5 707R?15"4': %' 3% &*0&02%* 3%2 01'4"2 0&:*5'4077%"2 3% (%21*% 31 60`' 3% "5 ?15"4':=   !6 D@BFM@FBG HF B6AACB@ G@ !6 JZ@RCHC!CEIG GJA!CQZG  r:34>: &5* "% CCWCaA NQ= $54""01*Rt":7422078 V= o46g%"8 qU= a1%707O8 %7 60""5)0*5'407 5;%6 "% 2%*;46% :6070(4?1% 3% "cA75%2 N]= V*:51)%*'8 C= r1(%51RV46g07O8 %' 5;%6 "% 201'4%7 3c17 >*01&% 3% '*5;54" 3% +, (%()*%28 4" 5 :': 34261': %' *%(574: 51 601*2 3% K *:1740728 &142 *%"1 &5* 17 >*01&% 3% "%6'1*% 60(&02: 3% II (%()*%2= L" 60(&0*'% Y 6g5&4'*%2=  R n7 653*% 6076%&'1%" 3:@474' "% 6076%&' 3% 60`' 3% "5 ?15"4':+ %' %D&"464'% "%2 70'4072 6077%D%2 P "5 ?15"4': 3%2 20472 %' "%2 60`'2 3572 "%2 :'5)"422%(%7'2 3% 257':= L" 5)0*3% 54724 "%2 34(%724072 3% "5 ?15"4': 3%2 204728 &*0&02% 17% 6"5224@465'407 3%2 3:@51'2 3% ?15"4': 3%2 20472I34@@:*%7'2 '<&%2 3% 60`'2 %7 :'5)"422%(%7' 3% 257':= Cc%2' "% @4" *01>%%' %D&"464'% "%2 ?14 &%*(%' 3% 60(&*%73*% "% &"57 3%2 6g5&4'*%2 %' "%2 6076%&'2 5)0*3:2= R T%1D 6g5&4'*%2 3% 2<7'gG2% 3c47@0*(5'407= n7 &*%(4%* 6g5&4'*% @54' "5 2<7'gG2% 3%2 '*5;51D 47'%*75'40751D &1)"4:2 %7'*% +,,J %' IJJS 5<57' :'134: "% 60`' 3% "5 ?15"4': 3%2 20472 3572 "5 &%*2&%6'4;% :6070(4?1% 3%                                                  +C0(&5*5'4;%(%7' 51 6076%&' 1'4"42: 3572 "% (4"4%1 47312'*4%"8 "% 60`' 3% "5 ?15"4': %7 :'5)"422%(%7' 3% 257': 601;*% "%2 60`'2 3% &*:;%7'407 3%2 3:@51'2 3% ?15"4': 3%2 204728 "%2 60`'2 3% (%21*% 3%2 3:@51'2 3% ?15"4': 3%2 20472 N6%2 3%1D 70'4072 &01;57' M'*% *%>*01&:%2 %7 60`'2 3c47;%2'422%(%7'2 3572 "5 ?15"4':O %' "%2 60`'2 "4:2 34*%6'%(%7' 51D 3:@51'2 3% ?15"4': 3%2 20472 %' E "%1* 60**%6'407 N60`' 3% "5 707R?15"4':O= I3% "5 6"5224@465'407 &*0&02:% &5* "cL72'4'1'% 0@ o%34647%8 "%2 3:@51'2 3% ?15"4': 3%2 20472 2% *:&5*'422%7' %7 2012R &5*'4*  f 1'4"425'407 3%2 *%2201*6%28 21* 1'4"425'407 3%2 *%2201*6%2 %' 3:@51'2 3% *:5"425'407 3c17 2047 53:?15' %7'*5u757' 17 :;:7%(%7' 473:24*5)"% :;4'5)"%=
CCWCaA R A75%2 b 2%*;46% :;5"15'407 :6070(4?1% b F14""%' IJJK R , R
U%2 60`'2 3% "5 ?15"4': %' 3% "5 707R?15"4': 3%2 20472 3572 "%2 :'5)"422%(%7'2 3% 257': P :'5' 3%2 "4%1D %' &*0&024'4072
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