關於12月品質論壇的初步看法 隨想供參考

隨想供參考

約在10年 台灣醫療品質學會成立並有活動

北區健保局即是”第四代管理”之顧客

負責人訪問或介紹稿見www.deming.com.tw

換句話說 台灣有自己的系統

我7年前在台大醫院的圖書館發現醫療管理和品管的英文期刊約7種
通向世界醫療品質的部分some healthcare quality links醫療品質網站(部分)

今年2007在”品質百科”和”品質論壇”都可以找到不少關於英國-台灣等醫療品質之資料 記得JUSE幾年前已出版這方面HANDBOOK

對於美國醫療系統的品管等(不錯的)簡介

可以參考Juran’s Quality Handbook第五版之

Healthcare Services 章

我看其中所根據的約三分之一是 T. Noland等應用Deming的改善應用(書台灣某電子公司的圖書館有 可能沒人看)—論文兩篇關於等待和延誤之研究—約1996

文中說到RAND在70年代對於界定系統—含顧客—之貢獻

紐約時報的社論

Editorial

America’s Lagging Health Care System Published: November 1, 2007

Americans are increasingly frustrated about the subpar performance of this country’s fragmented health care system, and with good reason. A new survey of patients in seven industrialized nations underscores just how badly sick Americans fare compared with patients in other nations. One-third of the American respondents felt their system is so dysfunctional that it needs to be rebuilt completely — the highest rate in any country surveyed. The system was given poor scores both by low-income, uninsured patients and by many higher-income patients.

The survey, the latest in a series from the Commonwealth Fund, is being published today on the Web site of Health Affairs, a respected health policy journal. Researchers interviewed some 12,000 adults in Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom and the United States.

Given the large number of people uninsured or poorly insured in this country, it was no surprise that Americans were the most likely to go without care because of costs. Fully 37 percent of the American respondents said that they chose not to visit a doctor when sick, skipped a recommended test or treatment or failed to fill a prescription in the past year because of the cost — well above the rates in other countries.

Patients here were more likely to get appointments quickly for elective surgery than those in nearly all the other countries. But access to primary care doctors, the mainstay of medical practice, was often rocky. Only half of the American adults were able to see a doctor the same day that they became sick or the day after, a worse showing than in all the other countries except Canada. Getting care on nights and weekends was problematic.

Often the care here was substandard. Americans reported the highest rate of lab test errors and the second-highest rate of medical or medication errors.

The findings underscore the need to ensure that all Americans have quick access to a primary care doctor and the need for universal health coverage — so that all patients can afford the care they need. That’s what all of the presidential candidates should be talking about.