Reliability of medical audit in quality assessment of medical care
Autor(a) principal: | |
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Data de Publicação: | 1996 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X1996000600009 |
Resumo: | Medical audit of hospital records has been a major component of quality of care assessment, although physician judgment is known to have low reliability. We estimated interrater agreement of quality assessment in a sample of patients with cardiac conditions admitted to an American teaching hospital. Physician-reviewers used structured review methods designed to improve quality assessment based on judgment. Chance-corrected agreement for the items considered more relevant to process and outcome of care ranged from low to moderate (0.2 to 0.6), depending on the review item and the principal diagnoses and procedures the patients underwent. Results from several studies seem to converge on this point. Comparisons among different settings should be made with caution, given the sensitivity of agreement measurements to prevalence rates. Reliability of review methods in their current stage could be improved by combining the assessment of two or more reviewers, and by emphasizing outcome-oriented events. |
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Reliability of medical audit in quality assessment of medical careReproducibilityHealth Care Quality AssuranceMedical AuditQuality of Health CareMedical RecordsMedical audit of hospital records has been a major component of quality of care assessment, although physician judgment is known to have low reliability. We estimated interrater agreement of quality assessment in a sample of patients with cardiac conditions admitted to an American teaching hospital. Physician-reviewers used structured review methods designed to improve quality assessment based on judgment. Chance-corrected agreement for the items considered more relevant to process and outcome of care ranged from low to moderate (0.2 to 0.6), depending on the review item and the principal diagnoses and procedures the patients underwent. Results from several studies seem to converge on this point. Comparisons among different settings should be made with caution, given the sensitivity of agreement measurements to prevalence rates. Reliability of review methods in their current stage could be improved by combining the assessment of two or more reviewers, and by emphasizing outcome-oriented events.Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz1996-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X1996000600009Cadernos de Saúde Pública v.12 suppl.2 1996reponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZ10.1590/S0102-311X1996000600009info:eu-repo/semantics/openAccessCamacho,Luiz Antonio BastosRubin,Haya Raheleng2006-08-30T00:00:00Zoai:scielo:S0102-311X1996000600009Revistahttp://cadernos.ensp.fiocruz.br/csp/https://old.scielo.br/oai/scielo-oai.phpcadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2006-08-30T00:00Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)false |
dc.title.none.fl_str_mv |
Reliability of medical audit in quality assessment of medical care |
title |
Reliability of medical audit in quality assessment of medical care |
spellingShingle |
Reliability of medical audit in quality assessment of medical care Camacho,Luiz Antonio Bastos Reproducibility Health Care Quality Assurance Medical Audit Quality of Health Care Medical Records |
title_short |
Reliability of medical audit in quality assessment of medical care |
title_full |
Reliability of medical audit in quality assessment of medical care |
title_fullStr |
Reliability of medical audit in quality assessment of medical care |
title_full_unstemmed |
Reliability of medical audit in quality assessment of medical care |
title_sort |
Reliability of medical audit in quality assessment of medical care |
author |
Camacho,Luiz Antonio Bastos |
author_facet |
Camacho,Luiz Antonio Bastos Rubin,Haya Rahel |
author_role |
author |
author2 |
Rubin,Haya Rahel |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Camacho,Luiz Antonio Bastos Rubin,Haya Rahel |
dc.subject.por.fl_str_mv |
Reproducibility Health Care Quality Assurance Medical Audit Quality of Health Care Medical Records |
topic |
Reproducibility Health Care Quality Assurance Medical Audit Quality of Health Care Medical Records |
description |
Medical audit of hospital records has been a major component of quality of care assessment, although physician judgment is known to have low reliability. We estimated interrater agreement of quality assessment in a sample of patients with cardiac conditions admitted to an American teaching hospital. Physician-reviewers used structured review methods designed to improve quality assessment based on judgment. Chance-corrected agreement for the items considered more relevant to process and outcome of care ranged from low to moderate (0.2 to 0.6), depending on the review item and the principal diagnoses and procedures the patients underwent. Results from several studies seem to converge on this point. Comparisons among different settings should be made with caution, given the sensitivity of agreement measurements to prevalence rates. Reliability of review methods in their current stage could be improved by combining the assessment of two or more reviewers, and by emphasizing outcome-oriented events. |
publishDate |
1996 |
dc.date.none.fl_str_mv |
1996-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X1996000600009 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X1996000600009 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0102-311X1996000600009 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz |
publisher.none.fl_str_mv |
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz |
dc.source.none.fl_str_mv |
Cadernos de Saúde Pública v.12 suppl.2 1996 reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
_version_ |
1754115717995692032 |