Evaluation of the performance of health services
Autor(a) principal: | |
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Data de Publicação: | 1991 |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/23796 |
Resumo: | Recent literature (up to 1988) on health service assessment in general and especially on hospital service assessment is reviewed, with special attention to its conceptual and methodological aspects. The history of this process is also examined, from the first attempts by the American College of Surgeons, through the Joint Commission for Hospital Accreditation activities up to more recent efforts. The Diagnosis Related Group methodology is commented especially, as well as its more recent complement, the severity of illness inidicators. Progress made in this field is briefly examined as in the light of the Brazilian situation. The origins of the growing international concern with this field are enumerated: soaring costs of health services; the recent growth in the number of medical malpractice suits; and the sharp increase in the complexity of health services. The sources of information used in the process, such as immediate observation (case-control type studies), medical records, and summary instruments already in use for payment or financial control purposes, are commented on. Mention is made of the deep influences of the assessment process on practice as in the case of the standardization of practices and procedures, staging of the pathological processes, trajectory-type studies; the utilization of tracer situations, and, finally, the most influencial on practice of all these assessment instruments: the diagnosis and treatment protocols, already in wide use in some medical fields such as cancer treatment even in developing countries. |
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Evaluation of the performance of health services Avaliação de desempenho de serviços de saúde Avaliação de processos e resultados (cuidados de saúde)^i1^stendêncAdministração hospitalar^i1^stendêncServiços de saúde^i1^snorOutcome and process assessment (health care)^i2^streHospital administration^i2^streHealth services^i2^sstanda Recent literature (up to 1988) on health service assessment in general and especially on hospital service assessment is reviewed, with special attention to its conceptual and methodological aspects. The history of this process is also examined, from the first attempts by the American College of Surgeons, through the Joint Commission for Hospital Accreditation activities up to more recent efforts. The Diagnosis Related Group methodology is commented especially, as well as its more recent complement, the severity of illness inidicators. Progress made in this field is briefly examined as in the light of the Brazilian situation. The origins of the growing international concern with this field are enumerated: soaring costs of health services; the recent growth in the number of medical malpractice suits; and the sharp increase in the complexity of health services. The sources of information used in the process, such as immediate observation (case-control type studies), medical records, and summary instruments already in use for payment or financial control purposes, are commented on. Mention is made of the deep influences of the assessment process on practice as in the case of the standardization of practices and procedures, staging of the pathological processes, trajectory-type studies; the utilization of tracer situations, and, finally, the most influencial on practice of all these assessment instruments: the diagnosis and treatment protocols, already in wide use in some medical fields such as cancer treatment even in developing countries. A partir da literatura recente (até 1988) a respeito da avaliação de serviços de saúde em geral e do desempenho hospitalar em particular, destacam-se os diferentes aspectos conceituais e metodológicos envolvidos, começando pelas primeiras tentativas no seio do Colégio Americano de Cirurgiões, passando pela criação e evolução da Comissão Conjunta de Acreditação de Hospitais americana, até os esforços e elaborações conceituais e metodológicas mais recentes. São destacados a metodologia dos grupos diagnósticos homogêneos ("diagnosis related groups" ou "DRGs") e os indicadores de gravidade ("severity of illness"). É comentada a evolução desse incipiente campo de conhecimento e de prática no ambiente nacional. São comentadas as origens do recente interesse internacional a respeito do problema, ou seja, o aumento generalizado de custos dos serviços de saúde, crescente aumento de demandas judiciais em alguns países e ainda o acentuado incremento de complexidade dos atos em muitas especialidades. Destacam-se as fontes de informação correntemente utilizadas no processo, ou seja, a observação direta (estudos caso/controle), os prontuários médicos e os instrumentos-resumo, freqüentemente utilizados para remuneração do atendimento. Mencionam-se as profundas influências na prática de saúde que o processo de avaliação tem introduzido, particularmente a padronização de procedimentos, o estadiamento de agravos, os estudos de trajetória, os relacionados a situações traçadoras ("tracers") e a alternativa que mais tem influenciado a prática de situações complexas de saúde, que são os protocolos diagnóstico-terapêutico s já amplamente utilizados em algumas áreas como a do tratamento de câncer, inclusive no Brasil. Universidade de São Paulo. Faculdade de Saúde Pública1991-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/2379610.1590/S0034-89101991000100013Revista de Saúde Pública; Vol. 25 No. 1 (1991); 64-71 Revista de Saúde Pública; Vol. 25 Núm. 1 (1991); 64-71 Revista de Saúde Pública; v. 25 n. 1 (1991); 64-71 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/rsp/article/view/23796/25832Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessAzevedo, Antonio Carlos de2012-05-29T15:57:29Zoai:revistas.usp.br:article/23796Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-05-29T15:57:29Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Evaluation of the performance of health services Avaliação de desempenho de serviços de saúde |
title |
Evaluation of the performance of health services |
spellingShingle |
Evaluation of the performance of health services Azevedo, Antonio Carlos de Avaliação de processos e resultados (cuidados de saúde)^i1^stendênc Administração hospitalar^i1^stendênc Serviços de saúde^i1^snor Outcome and process assessment (health care)^i2^stre Hospital administration^i2^stre Health services^i2^sstanda |
title_short |
Evaluation of the performance of health services |
title_full |
Evaluation of the performance of health services |
title_fullStr |
Evaluation of the performance of health services |
title_full_unstemmed |
Evaluation of the performance of health services |
title_sort |
Evaluation of the performance of health services |
author |
Azevedo, Antonio Carlos de |
author_facet |
Azevedo, Antonio Carlos de |
author_role |
author |
dc.contributor.author.fl_str_mv |
Azevedo, Antonio Carlos de |
dc.subject.por.fl_str_mv |
Avaliação de processos e resultados (cuidados de saúde)^i1^stendênc Administração hospitalar^i1^stendênc Serviços de saúde^i1^snor Outcome and process assessment (health care)^i2^stre Hospital administration^i2^stre Health services^i2^sstanda |
topic |
Avaliação de processos e resultados (cuidados de saúde)^i1^stendênc Administração hospitalar^i1^stendênc Serviços de saúde^i1^snor Outcome and process assessment (health care)^i2^stre Hospital administration^i2^stre Health services^i2^sstanda |
description |
Recent literature (up to 1988) on health service assessment in general and especially on hospital service assessment is reviewed, with special attention to its conceptual and methodological aspects. The history of this process is also examined, from the first attempts by the American College of Surgeons, through the Joint Commission for Hospital Accreditation activities up to more recent efforts. The Diagnosis Related Group methodology is commented especially, as well as its more recent complement, the severity of illness inidicators. Progress made in this field is briefly examined as in the light of the Brazilian situation. The origins of the growing international concern with this field are enumerated: soaring costs of health services; the recent growth in the number of medical malpractice suits; and the sharp increase in the complexity of health services. The sources of information used in the process, such as immediate observation (case-control type studies), medical records, and summary instruments already in use for payment or financial control purposes, are commented on. Mention is made of the deep influences of the assessment process on practice as in the case of the standardization of practices and procedures, staging of the pathological processes, trajectory-type studies; the utilization of tracer situations, and, finally, the most influencial on practice of all these assessment instruments: the diagnosis and treatment protocols, already in wide use in some medical fields such as cancer treatment even in developing countries. |
publishDate |
1991 |
dc.date.none.fl_str_mv |
1991-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/23796 10.1590/S0034-89101991000100013 |
url |
https://www.revistas.usp.br/rsp/article/view/23796 |
identifier_str_mv |
10.1590/S0034-89101991000100013 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/23796/25832 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 25 No. 1 (1991); 64-71 Revista de Saúde Pública; Vol. 25 Núm. 1 (1991); 64-71 Revista de Saúde Pública; v. 25 n. 1 (1991); 64-71 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221775542353920 |