Reliability of medical audit in quality assessment of medical care

Detalhes bibliográficos
Autor(a) principal: Camacho,Luiz Antonio Bastos
Data de Publicação: 1996
Outros Autores: Rubin,Haya Rahel
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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spelling 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
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