E.A. Tarasenko
National Research University. Higher School of Economics, Moscow
Abstract.The main purpose of public health is quality
improvement of medical care. Ranking of healthcare organizations is
rather effective information and marketing tool for external quality
management of medical care. The author reviewed international experience
in selecting quality measures of medical care to rank healthcare
organizations that could be used as a methodological framework for
designing rankings of healthcare organizations in Russia.
The aim of the study was to identify methodological
basis of international rankings of health care facilities: major
indicators and criteria for evaluating quality of medical care.
Methodology. The author analyzed methods for developing
rankings of international healthcare organizations through the analysis
of international scientific sources and information made public by state
organizations working in the area of health management as well as
through four expert interviews with experts in health management. The
author attempts to structure indicators and criteria for quality
evaluation of medical care based on Donabedian’s triad as well as
identify definitions, content and balance between clinical and
non-clinical indicators.
Results and Conclusions: In general, international ranking
of healthcare organizations, developed in partnership with governmental
bodies, or on the basis of statistics collected by governmental bodies,
are deeply and thoroughly detailed and include over 20 quality measures
(with the detailed definition of each indicator) . The subject of such
ranking can be both clinical and non-clinical quality indicators of
health care facilities that could be tentatively structured according to
the three interrelated factors of quality of medical care according to
Donabedian’s triad (structure, process and outcome), including public
opinion about reputation of a health care facility.
The main recommendation for the Russian public health regarding
healthcare organizations’ ranking that is based on international
experience is to ensure detailed clinical statistical performance
indicators of healthcare organizations according to the tree components
of Bonabedian’s quality triad along with expert and patient’s appraisal
of health care facility’s reputation regarding quality of medical care.
Keywords. Ranking of healthcare organizations; quality
of medical care; clinical and nonclinical quality indicators;
Donabedian’s triad; information and marketing tool for quality
management of medical care.
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