رابطه استقرار شاخص‌های کیفی ارزشیابی با کیفیت خدمات درمانی در بیمارستان‌های پایلوت دانشگاه علوم پزشکی گلستان

Abstract

Introduction: To promote the processes of providing medical services, patient's rights and establishing uniformity in treatment policy, the evaluation quality indexes were communicated to all general hospitals in 2002. This study evaluates the implementation of managed care guideline before their communication as evaluation quality indexes of hospitals and their relationship with communication and quality degree of conducted services. Methods: This study was an analytical study based on information in the records of patients, before and after the communication of managed care guideline. The statistical population including the records of patients who underwent surgery or had delivered in the pilot hospitals affiliated to Golestan University of Medical Sciences in 2002 and 2007, Iran. The sample included 792 cases which were selected by stratified method. Data collected using three types of checklists and a standard information form communicated by the Ministry of Health. Obtained data analyzed by SPSS 16 software and χ 2 test. Results: The preoperative assessment guideline was performed in 5.1% and 32.1% of evaluated documents in 2002 and 2007, respectively (P < 0.001). The prophylactic antibiotic guideline was performed in 31.6% and 44.9% of documents in 2002 and 2007, respectively (P < 0.001). The pain relief guideline was fully performed in 77.8% and 85.1% of documents in 2002 and 2007, respectively (P = 0.001). Cesarean section ratio to total deliveries in investigated hospitals were 49% in 2002 and decreased significantly to 42% in 2007 (P < 0.001). Most cesarean indication belongs to repeated cesarean section indication. Generally, in all investigated indexes there were positive and significant relation between establishing of Evaluation quality indexes and services quality. Conclusion: Implementation of managed care guideline led to improvement of quality in medical services. Establishing of guarantees and continuous rechecking regarding the quality assessment communications, could improve the quality of services in the future. Key words: Indicators; Quality of Healthcare; Evaluation; Hospitals.