美研究如何降低因肺炎而住院治疗的比例

 
使用一种质量提高系统能够提醒医生注意肺炎患者的治疗指南，从而可以提高整体医疗质量并降低不必要的住院治疗。

这是由匹兹堡大学医学院(Pittsburgh , PA, USA)和匹兹堡VA医疗保健系统开展的一项研究的结果。这些研究结果发表在2005年12月的《内科学年报》。

这项研究设计了32家医院急诊科的3,200多例诊断为肺炎的患者，这些患者由于肺炎而出现了各种不良预后的危险。所有参见研究的急诊科同意遵循统一的治疗指南，该指南是根据美国肺炎治疗专家的意见而制定的。

这些急诊科被随机分配为低强度、中等强度或者高强度机构，--这些名称反应了各家急诊科采取的反馈、加强和持续的质量提高的水平和强度。

据估计仅仅在美国每年大约有5百万例患者被诊断为肺炎，但是尽管这种疾病发病率较高，医生经常高估了患者的死亡率，从而导致不必要而且费用昂贵的住院治疗。

Reducing Pneumonia Hospitalizations
 
Implementation of a quality-improvement system reminds physicians of treatment guidelines for pneumonia patients, which leads to better overall care and fewer unnecessary hospitalizations.

These were the conclusions of a study conducted by investigators from the University of Pittsburgh School of Medicine (Pittsburgh , PA, USA) and the Pittsburgh VA Healthcare System. The findings were published in the December 2005 issue of the Annals of Internal Medicine.

The study involved 32 hospital emergency departments and more than 3,200 patients diagnosed with pneumonia who posed varying risks of adverse outcomes from the disease. All participating emergency departments agreed to follow uniform practice guidelines, which were based on expert consensus of U.S. experts in pneumonia care.

The emergency departments were randomly assigned as low-intensity, moderate-intensity or high-intensity sites--designations reflecting the level and intensity of feedback, reinforcement, and continuous quality improvement activities that each emergency department would carry out relevant to its pneumonia patients.

An estimated 5 million pneumonia cases are diagnosed each year in the United States alone, but despite its prevalence, physicians frequently overestimate the probability of death in many pneumonia patients, leading to potentially unnecessary and costly hospitalizations.