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KMID : 1142920180020010045
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Public Health Affairs
2018 Volume.2 No. 1 p.45 ~ p.55
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Discrimination Ability of Indicators for the Healthcare Quality Evaluation Grant Initiative in Korea National Health Insurance Program
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Kang Hee-Chung
Ha Sol-Leep
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Abstract
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Purpose: We examined how well each quality indicator discriminate quality differences among hospitals in the Healthcare Quality Evaluation Grant initiative of Korea National Health Insurance Program.
Methods: We analyzed hospital-level quality indicators which were used for the decision of 2016 Healthcare Quality Evaluation Grant initiative. We examined each indicator’s discrimination ability using the criteria (median≥95 percentile & inter-quartile range percent<4.5%)
Results: Current Healthcare Quality Evaluation Grant initiative is mainly composed of structure or process indicators. Most structural quality indicators of tertiary general hospitals have no discrimination ability unlike general hospitals.
Conclusions: This study shows that indicators of the Quality Evaluation Grant initiative are systematically reflecting structural differences between tertiary general hospitals and general hospitals. We need to restructure quality indicators from structure-based to outcome-based and to examine the introduction of absolute rating approaches for overcoming limitations of current relative ratings and improve its effects as a quality based P4P program.
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KEYWORD
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uality of care, hospital, quality assessment, quality evaluation
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