Quality monitoring in health care: Proposals for new regulations

A number of pro-quality initiatives initiated by the Minister of Health, the National Health Fund, patient organizations and the medical community are currently underway. However, so far the introduction of quality requirements is not associated with sufficient and systematic evaluation of their fulfillment. A systematic approach to the issue of quality in health care requires first of all monitoring and evaluation of the phenomenon of "insufficient quality" and the scale of its occurrence, identification of the main causes and consequences of its occurrence, and introduction of solutions to stimulate improvement.

Implementation of healthcare quality indicators and their systematic monitoring will allow:

1) Continuously improve clinical practice and enhance the effectiveness of diagnosis and treatment by systematically assessing clinical quality indicators;

2) to achieve comparability of healthcare providers providing publicly funded healthcare services in terms of the quality and effectiveness of the care offered and to make the results available to the public;

3) Creating conditions to financially motivate health care providers providing publicly funded health care services to improve quality levels;

4) more efficient use of public funds in the area of health.

It is therefore necessary to introduce a regulation that will define the scope of the area covered by monitoring aimed at its improvement. The new regulation will ensure that patients, medical professionals and healthcare providers have access to widespread, reliable, objective and comparable information on the quality of care provided.

The recommended solution is to implement health care quality indicators, which will allow to assess the quality of publicly funded health care services provided in relation to areas:

1) clinical - understood as a set of indicators relating to the level and effects of the health care services provided, described by parameters:

(a) therapeutic effect,

(b) repeat hospitalizations for the same cause,

(c) mortality after procedures: during hospitalization at 30 days, 90 days and one year after the end of hospitalization,

(d) experience in performing certain healthcare services,

(e) the structure of medical procedures performed in cases of specific health problems;

2) consumer - understood as the results of surveys of patients' opinions on the organization of the healthcare delivery process;

3) management - understood as a set of indicators relating to the efficiency of the use of resources and the implementation of management systems, described by parameters relating to:

(a) have an accreditation or other certificate or certificate of quality issued by an independent accredited body,

(b) the degree of use of resources at the entity's disposal,

(c) length of hospitalization,

(d) the structure of the health care services provided.

Source: RCL