高质量的牙科护理:一个复杂的课题。

Revue belge de medecine dentaire Pub Date : 2008-01-01
E Mortelmans, J Berghmans, M Justens
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引用次数: 0

摘要

评估牙科护理的质量取决于方法。从患者的角度来看,对护理质量的感知不仅取决于治疗的纯粹技术质量,还取决于医患之间的沟通、组织和管理水平。从主要关注治疗结果的牙科专业人员的角度来看,另一方面,这种患者判断综合护理质量的方式可能会令人沮丧。毕竟,由于口头表达能力和组织能力,即使诊断和治疗质量不好,也能给人留下好印象,这可能是每个牙科专业人员都能做到的。正如人们所期望的那样,无论如何,是否有可能衡量护理的最终质量是否符合患者应得的护理标准?证明治疗结果是困难的,因为它取决于太多的变量,其中一些(如病人的依从性)可能超出牙科保健专业人员的控制范围。这就是为什么现代临床指南和协议强调创造理想的治疗步骤和条件,最可能导致最有利的治疗结果。最后,当局和政策制定者越来越渴望从成本效益的角度衡量临床护理质量的指标。在这方面,作者指出,在实际情况下,为每个人提供廉价的高质量牙科护理已经过时了。为了获得可负担性或可获得性,定义医疗质量的限制将是一项棘手的工作,需要合理的科学思维与伦理平衡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Quality dental care: a complex subject].

Assessing the quality of dental care depends on the approach. From the patient's perspective the perception of the quality of care depends as much on the pure technical quality of the treatment as on the level of patient - doctor communication, organisation and administration experienced in relation to the treatment. From the point of view of the dental professionals who tend to focus primarily on outcome of treatment on the other hand, this way of patient's judging integrated quality of care might be quite frustrating. After all, thanks to verbal and organisational skills, making good impression despite bad diagnostic and treatment quality might come within reach of simply every dental professional. As desirable it might be, is it possible anyhow to measure if the ultimate quality of care meets the standards of care patients deserve? Certifying outcome of treatment is difficult since it depends on too much variables amongst which some (such as patient's compliance) might fall out of reach of control of the dental care professionals. That's why modern clinical guidelines and protocols stress on creating the ideal treatment steps and conditions most likely leading to the most favourable treatment result. Finally authorities and policymakers aspire more and more to the idea of indicators measuring clinical quality of care from a cost effectiveness point of view. In this respect the authors state that cheap high quality dental care for everybody has become out of date in the actual context. And defining limits to quality of care in order to gain affordability or accessibility, is going to be a tricky exercise requiring sound scientific thinking balanced with ethics.

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