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평가지표 개발 가이드라인 마련 연구

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Type
Research report
Author(s)
이후연조경희윤난희이미선김지은박소연김동준김성주권남희임지환
Issued Date
2022-12
Publisher
건강보험심사평가원
URI
https://repository.hira.or.kr/handle/2019.oak/3112
Table Of Contents
제1장 서론 1
1. 연구 배경 및 목적 ·················································································· 3
가. 요양급여 적정성 평가 ················································································· 3
나. 연구의 배경과 필요성 ················································································· 7
다. 연구 목적 ·································································································· 7
2. 연구 내용 및 방법 ·················································································· 8
가. 연구 내용 ·································································································· 8
나. 연구 방법 ·································································································· 9

제2장 국내외 평가지표 개발 현황 11
1. 미국의 Center for Medicare & Medicaid(CMS) ································ 13
2. 미국의 Agency for Healthcare Research and Quality’s(AHRQ) ········ 38
3. 미국의 National Quality Forum(NQF) ·················································· 47
4. 영국의 Shared commitment to quality ·············································· 55
5. 영국의 National Institute for Health and Care Excellence(NICE) ······ 58
6. 한국 국가건강검진 검진항목 선정 ··························································· 63

제3장 평가지표 개발의 문제점 및 개선사항 67
1. 의견 수렴 과정 ···················································································· 69
2. 주요 내용 ···························································································· 70
3. 개선 방안 ···························································································· 70

제4장 평가지표 개발 가이드라인 73
1. 의료의 질을 이해하기 위한 기본 개념 ···················································· 75
가. 바람직한 보건의료의 특성 ·········································································· 75
나. 의료의 질 정의와 개념 ·············································································· 77
다. 의료의 질 향상 접근방안 ··········································································· 78
라. 의료환경의 변화와 의료의 질 평가 ····························································· 81
2. 평가지표 개발의 기본원칙 ····································································· 81
가. 평가지표의 개념과 유형 ············································································· 81
나. 개발한 평가지표에 대한 평가 기준 ····························································· 83
3. 평가지표 개발의 단계별 지침 ································································· 84
가. 평가지표 개발 계획 수립 ··········································································· 85
나. 후보지표 개발 ·························································································· 95
다. 후보지표 검증 ························································································ 107
라. 후보지표 평가 ························································································ 113
마. 최종 평가지표 선정 ················································································· 119

제5장 제언 125
1. 국내외 평가지표 개발 현황을 통한 시사점 ············································ 127
가. 평가지표 개발 우선순위 설정을 위한 시사점 ·············································· 127
나. 평가지표 개발 가이드라인 개발을 위한 시사점 ··········································· 128
2. 국가 차원의 질 향상 정책목표와 우선순위 영역 도출 ····························· 129
3. 적정성 평가 영역의 주요 우선순위 도출 ··············································· 134
가. 국가수준의 의료의 질 격차를 확인하고 평가영역의 우선순위 결정 ··············· 134
나. 평가 영역별 평가지표의 균형적 분포 ························································ 135

◾ 참고 문헌 ··························································································· 139
Publisher
건강보험심사평가원
Location
KOR
Citation
이후연. (2022-12). 평가지표 개발 가이드라인 마련 연구.
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