Trends in care quality in China from 2011 to 2017: An analysis based on the National Specific (Single) Disease Monitoring System

作者：Chang Yin, Jingkun Li, Meng Wen, Shuang Hou, Dan Liu, Mengyang Liu, Lei Yu, Ruize Guo, Xinhao Han, Meina Liu · 发表于：Journal of Global Health · 年份：2023 · DOI：10.7189/jogh.13.04045 · 被引用次数：7 · 研究领域：Primary Care and Health Outcomes、Healthcare Systems and Reforms、Sepsis Diagnosis and Treatment

Background: The Ministry of Health of China conducted a study targeting in single-disease quality control in 2009, aimed to strengthen quality management and improve health care services. This study retrospectively investigated the trends of quality indicators for six monitored diseases 2011-2017 to evaluate the improvement of care quality for the first batch of single-disease. Methods: We extracted data from the National Specific (Single) Disease Monitoring System for 2011-2017. We focused on six conditions: acute myocardial infarction, heart failure, community-acquired pneumonia, coronary artery bypass graft, hip / knee replacement, and acute ischemic stroke. A total of 56 quality indicators (QIs) were adopted to monitor the quality change and determine the trends in care quality. We also calculated the hospital process composite performance (HPCP) using a denominator-based weighting method for each hospital per year. The estimated annual percentage changes (EAPC) 2011-2017 were calculated at national and regional levels. Results: The results showed that use of four QIs had significant downward trends, whereas 25 QIs (including reversed indicators) showed significant upward trends from 2011 to 2017. The greatest improvement was observed in CAP-4 (antibiotic treatment within four hours after admission to the hospital for critical pneumonia) in the central region (EAPC = 48.36, 95% CI = 15.92-89.87); while the largest decrease appeared in AIS-1 (thrombolytic therapy within 4....