Artikel
Quality Indicators in Neurosurgery- Which are presently substantiated? A systematic review
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Autoren
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Stephanie Schipmann
- Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
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Michael Schwake
- Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
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Eric Jose Suero Molina
- Universitätsklinikum Münster, Klinik und Poliklinik für Neurochirurgie, Münster, Deutschland
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Norbert Roeder
- Universitätsklinikum Münster, DRG Research Group, Münster, Deutschland
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Wolf-Ingo Steudel
- Homburg, Deutschland
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Nils Warneke
- Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
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Walter Stummer
- Universitätsklinikum Münster, Klinik und Poliklinik für Neurochirurgie, Münster, Deutschland
| Veröffentlicht: | 9. Juni 2017 |
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Gliederung
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Objective: Being a high-cost specialty due to the use of advanced technology, the field of neurosurgery – as many other medical specialties - has come under close scrutiny through health economists due to rising financial pressures. Consequently, policy makers and health care administrators have shifted the focus towards an analysis of the quality of delivered care and have begun applying quality measures that are easily available but may be inadequate and inaccurate for the speciality of neurosurgery.
Methods: To elucidate which quality indicators are scientifically founded and thus potentially justifiable as measures of quality, we performed a systematic literature review on indicators that are presently employed or that are being contemplated in the field of cranial neurosurgery. A total of eight quality indicators were found and studies were methodologically evaluated according to the AIRE (Appraisal of Indicators through Research and Evaluation) criteria.
Results: The mainly discussed quality indicators were length of hospital stay, all cause readmission rate and unplanned reoperation rate. Our review indicates that these presently used or proposed quality indicators for neurosurgery lack scientific rigour and are restricted to rudimentary measures and that further research is necessary.
Conclusion: Neurosurgeons need to define their own quality indicators and actively participate in the validation of these quality indicators to provide the best possible patient outcomes. More reliable clinical registries, obligatory for all neurosurgical services, should be introduced as a basis for the establishment of such indicators with risk-adjustment being an important element of any such indicators.
