医疗质量监控的经验贝叶斯方法
Empirical Bayes methods for monitoring health care quality
摘要：
本文讨论了经验贝叶斯方法重复质量比较的医疗机构使用的数据，从荷兰VOKS研究，每年监测的相对性能和质量，几乎所有的荷兰妇科中心就不同方面的分娩发生在这些中心。本文可以看作是托马斯，朗福德和Rolph和戈尔茨坦和Spiegelhalter的开创性工作的延伸。本文首先介绍了逻辑斯谛回归中中心效应的一个新的简单粗略估计。接下来，给出了给定所有数据的中心的预期百分位数的简单估计和基于预期百分位数的中心排名的度量。最后，探讨了时间维度，并讨论了预测下一年业绩的方法。
英文摘要：
The paper discusses empirical Bayes methodology for repeated quality comparisons of health care institutions using data from the Dutch VOKS study that annually monitors the relative performance and quality of nearly all Dutch gynecological centres with respect to different aspects of the childbirths taking place in these centres. This paper can be seen as an extension of the pioneering work of Thomas, Longford and Rolph and Goldstein and Spiegelhalter. First of all, this paper introduces a new simple crude estimate of the centre effect in a logistic regression setting. Next, a simple estimate of the expected percentile of a centre given all data and a measure of rankability of the centres based on the expected percentiles are presented. Finally, the temporal dimension is explored and methods are discussed to predict next years performance.
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