한국의료질향상학회지 (Quality Improvement in Health Care)
- 제7권2호
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- Pages.204-216
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- 2000
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- 1225-7613(pISSN)
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- 2288-078X(eISSN)
미국 Medicare 투석환자 치료의 질 지표 개발 : 4가지 주요 치료영역을 바탕으로
Developing a Composite Quality Indicator to Assess The Quality of Care for US Medicare End-stage Renal Disease Patients
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강혜영
(연세대학교 대학원 보건학과)
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Kang, Hye-Young
(Department of Public Health, The Graduate School, Yonsei University)
- 발행 : 2000.12.30
초록
Background : There has been a concern that the quality of care provided to end-stage renal disease (ESRD) patients in the United States may not be as good as recommended. This paper illustrates a composite measure to assess, the quality of care received by ESRD patients undergoing in-center hemodialysis by incorporating outcomes for 4 major treatment areas. The 4 treatment areas are: dialysis treatments, anemia control, nutritional management, and blood pressure control. Methods : The major data source for the study was the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave 1 (DMMS-1) d Sixteen categories of a composite quality indicator were constructed by combining 4 dichotomous variables (16=2*2*2*2). representing the optimal vs. less than optimal level of outcome for each of the 4 treatment outcome measure respectively. Optimal outcome level for each treatment area was defined based on the recommendation from the National Kidney Foundation: (a) delivered dialysis doses (Kt/V)