Abstracts by key term: Quality; Intervention; inpatient care; Human studies
The Hospital Structure Act, which came into force on January 1, 2016, provides for the inclusion of quality data in inpatient health care that is relevant to remuneration and planning. In order to be able to categorize quality, the legislator uses Donabedian's model for structural, process and result quality (e.g.: §136 Social Security Code V). This model implies that improving the quality of structure and processes can improve the quality of results (Donabedian 1966; Donabedian et al. 1987). In this context, good evidence about the strength of the controllable influence of structure- and/or process-related interventions on the treatment outcome was called for early on (Donabedian 1980; Institute of Medicine 1990). Following the implementation of the KHSG, the G-BA published both planning-relevant structural indicators and a cross-sectoral guideline for the design of internal quality management (Joint Federal Committee 2015, 2016). From the perspective of evidence-based medicine, however, it can be said that previous reviews indicated that there was often weak evidence for influencing the quality of results through complex interventions at the structural or process level (Conry et al. 2012; Khan/Ollenschläger 2014). However, a current critical analysis of the published studies on the effect of complex quality interventions in the setting of the German healthcare system is currently missing. We therefore analyzed the literature on the influence of planned complex interventions at the structural and/or process level on the quality of results in inpatient settings in the German healthcare system using a systematic review.