A framework for the development of maternal quality of care indicators

被引:17
作者
Korst, LM
Gregory, KD
Lu, MC
Reyes, C
Hobel, CJ
Chavez, GF
机构
[1] Childrens Hosp Los Angeles, Saban Res Inst, Los Angeles, CA USA
[2] Univ So Calif, Keck Sch Med, Dept Pediat, Los Angeles, CA USA
[3] Univ So Calif, Keck Sch Med, Div Res Children Youth & Families, Los Angeles, CA USA
[4] Univ So Calif, Keck Sch Med, Div Neonatal Med, Los Angeles, CA USA
[5] Univ So Calif, Keck Sch Med, Dept Obstet & Gynecol, Los Angeles, CA USA
[6] Cedars Sinai Med Ctr, Burns & Allen Res Inst, Los Angeles, CA 90048 USA
[7] Univ So Calif, David Geffen Sch Med, Dept Obstet & Gynecol, Los Angeles, CA USA
[8] Univ Calif Los Angeles, David Geffen Sch Med, Div Maternal Fetal Med, Los Angeles, CA USA
[9] Univ Calif Los Angeles, David Geffen Sch Med, Div Womens Hlth Serv Res & Policy, Los Angeles, CA USA
[10] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA USA
[11] Univ Calif Los Angeles, Sch Publ Hlth, Dept Community Hlth Serv, Los Angeles, CA 90024 USA
[12] Agcy Healthcare Res & Qual, Rockville, MD USA
关键词
quality indicators; health care; maternal health services; pregnancy;
D O I
10.1007/s10995-005-0001-y
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: In collaboration with the California Department of Health Maternal and Child Health Branch, the authors formed a Working Group to identify potential clinical indicators that could be used to inform decision making regarding maternal health care quality. Objective: To develop potential indicators for the assessment of maternal health care quality. Materials and Methods: A Working Group was convened to review information from the published literature and expert opinion. Selection of potential indicators was guided by the following goals: 1) To identify key areas for routine aggregate monitoring; 2) To include perspectives of relevant stakeholders in maternal health care services 3) To include measures that are comprehensive and reflect a balance between maternal and fetal interests; and 4) To develop measures that would be valid, generalizable, mutable, and feasible. Results: Ninety potential indicators were identified. Each underwent a thorough review based on: its definition, objective, and validity; its contribution to innovation; the cost and timeliness of implementation; its feasibility, acceptability, and potential effectiveness; and its compatibility with ethics, values, and social policy. This process yielded 24 final indicators from the following categories: Health Status and Access (e.g., availability of 24 h inpatient anesthesia); Preconception and Interconception Care (e.g., Pap smear use); Antenatal Care (e.g., hospitalization for uncontrolled diabetes or pyelonephritis); Labor and Delivery Care (e.g., chorioamnionitis or obstetrical hemorrhage), and Postpartum Care (e.g., rate of postpartum visits). Conclusions: These potential indicators, representative of the women's health continuum, can serve as a foundation to structure the development of consensus and methods for maternal health care quality assessment.
引用
收藏
页码:317 / 341
页数:25
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