Measuring, monitoring, and managing quality in Germany's hospitals.
In German hospitals, quality measurement, monitoring, and management have undergone considerable development. This includes an array of mandatory measures, including a nationwide benchmarking exercise based on 194 indicators. Because of better and deeper coding of diagnoses, procedures, and demographic information since the introduction of the diagnosis-related group (DRG) system, two further "generations" of instruments have been developed: quality measurement performed at the provider (hospital) level using administrative data, and long-term performance measurement using administrative data at the payer level. All three approaches have specific pros and cons concerning validity regarding final outcomes and resistance against manipulation.
Busse
Reinhard
R
Department of Health Care Management at the Technische Universitaet, Berlin, Germany. rbusse@tu-berlin.de
Nimptsch
Ulrike
U
Mansky
Thomas
T
D005858:Germany; D006761:Hospitals / Q000592:standards*; D006801:Humans; D011785:Quality Assurance, Health Care; D017749:Total Quality Management