Coûts de la qualité et de la non qualité des soins dans les établissements de santé état des lieux et propositions - Cost quality non-quality

Has

Description

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

Sujets

• Économie de la santé

Informations

• Publié par: haute-autorite-sante-qualite-et-securite-soins
• Publié le: 01 juillet 2004
• Nombre de lectures: 27
• Licence : En savoir +
  Paternité, pas d'utilisation commerciale, partage des conditions initiales à l'identique
• Langue: Français

Extrait

Cost of quality and non-quality in care provided by healthcare organisations – Current situation and proposals 1 Aquitaine Committee for Coordination of Clinical Assessment and Quality (CCECQA)and  2 Haute Autorité de santé (French National Authority for Health), Saint-Denis La Plaine, France Authors: F. Saillour-Glénisson 1 MD, N. Préaubert 2 MD    Aims -professionals in healthcare organisations (HCOs) aware of the economicto make dimension of quality -to provide information on the cost of quality and non-quality -to propose working tools for measuring the cost of quality. This report also updates the ANAES report published in 1998.   Results and conclusions (i)Frequency of occurrence of deficiencies of quality of care. data available for The French HCOs pinpoint the most common areas of non-quality such as adverse events, unjustified interventions, and unjustified hospital stays. These areas represent potential savings through improvements in quality of care. (ii)Cost of deficiencies of quality of care.There are very few data for French hospitals, and poor study design makes them unreliable. Foreign studies have shown that deficiency- related excess costs vary according to type of deficiency. The most expensive are: infection generally, and postoperative infection; bacteraemia, pneumonia, drug-related adverse events, hospitalisations and inappropriate prescribing. (iii)Positive clinical and economic impact of interventions to prevent deficiencies. Studies published in France and abroad agree that the following may be useful: continuing quality improvement programmes, interventions to prevent nosocomial infections, and cost rationalisation programmes. There is evidence that these initiatives are profitable in the medium term, but no figures are available for the long term. (iv)between costs and quality of care.Relationship  The studies analysed (none were French) found that the relationship is neither simple nor unique and that it depends on factors which are specific to HCOs, patients and the economic context of the analysis. (v)Working instrument. working group developed worksheets as an initial working The instrument. These worksheets are designed to encourage HCOs to measure frequency of occurrence and mean costs of some deficiencies of quality of care.   Methods ANAES systematically searched the Medline, Embase and Pascal databases, useful websites and the grey literature, between 1990 and 2003. After the literature search had been completed and studies selected, a literature review report was produced. This document was discussed with a working group (19 experts) at 4 meetings and then submitted to a multidisciplinary group of peer reviewers (22 experts).   Looking ahead To remedy the lack of information, studies must be carried out in a representative sample of French departments and HCOs:  (i) to measure the cost of the main deficiencies of quality of care; (ii) to measure the cost of investing in quality in order to encourage HCOs in their quality initiatives and embed their quality functions.     HAS. 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France tel: [phone], fax: [phone], www.has-sante.fr