A epidemiologia na avaliação da qualidade: uma proposta

Cadernos de Saúde Pública

Daphne Rattner¹ 

[1] ,Instituto de Saúde Núcleo de Investigação em Saúde da Mulher e da Criança São Paulo SP ,Brasil

关键词: Epidemiology;    Health Services;    Perinatal Care;    Quality of Health Care;    Evaluation Studies;    Epidemiologia;    Serviços de Saúde;    Avaliação da Qualidade dos Cuidados de Saúde;    Assistência Perinatal;    Obstetrícia;   

DOI  :  10.1590/S0102-311X1996000600004

来源: SciELO

【 摘 要 】

This paper proposes a strategy for defining indicators to assess the quality of the process of health care, based on the identification of the objectives of the care being delivered and on the verification of whether the technical guidelines for the procedures are being enforced. The article goes on to apply the proposed methodology to the process of health care during childbirth, based on a perspective of comprehensive care and adopting both an individual and collective risk approach. It uses a data bank of 4,558 Simplified Perinatal Clinical Histories (CLAP/PAHO/WHO) from 12 hospitals.The indicators selected were: V.D.R.L., Rh blood typing, antitetanus vaccination, rate of cesarean sections, reception of the baby by a pediatrician at birth, Apgar score, evaluation of the gestational age by physical exam, rooming-in, exclusive breastfeeding upon discharge, and referral for a puerperal consultation. Methods for classification of hospitals were the sum of their scores for each indicator, gold standard, and ranking. This methodology warranted identification of one hospital with excellent quality of care, five with good care, two with fair care, and four whose performances were completely unsatisfactory. Finally, some remarks on the assessment of quality of health care are made and future developments are proposed.

【 授权许可】

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