[Methodology for estimating standards for quality in health care: the case of acute myocardial infarction]
This study outlines the steps for estimating quality standards in health care to be used in quality improvement programs and funding mechanisms, focusing on the case of acute myocardial infarction (AMI). The methodology is based on existing scientific evidence related to technologies currently used for treatment of AMI in Brazil. Hospital lethality was estimated for selected sets of technologies corresponding to more or less complex units. Basic parameters used for estimating standards were efficacy (percentage reduction in death rates ratio) and the percentage corresponding to the referent (indications) associated with each technology. Standards were adjusted for age and time interval from onset to hospital admission. Estimated standard hospital lethality varied from 28% (traditional care wards) to 8.5% (relatively complex coronary care units). Limitations of the proposed methodology are discussed.
Silva
LK
Núcleo de Avaliação da Atenção Médica e Tecnologias em Saúde, Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21041-210, Brasil.
Escosteguy
CC
Machado
CV