J Altern Complement Med. 2003 Apr; 9(2): 193-206.

"Quality profiling" for complementary medicine: the example of a hospital for traditional Chinese medicine.

Melchart D, Weidenhammer W, Linde K, Saller R.

Centre for Complementary Medicine Research, Department of Internal Medicine II, Technische Universit�t M�nchen, M�nchen, Germany. [email protected]

OBJECTIVE: The goal of the methodological approach of "quality profiling" for complementary and alternative medicine (CAM) is to offer an empirical database that would enable different participants in the health care system to evaluate the quality of a medical provider. METHODS: Quality profiling is a structured way of describing quality on the levels of infra-structure, patients, medical interventions, outcomes, and quality assurance related to one specific provider. As part of a program called "quality management and research," this type of profiling constitutes one basic step for generating knowledge in terms of evidence-based medicine as well as confidence-based medicine. Quality profiling is exemplified by a hospital for Traditional Chinese Medicine in Germany. Within 1 year all in-patients were included in the database using questionnaires for physicians and patients at the time of admission, discharge from the hospital, and follow-up inquiries at intervals up to 1 year after discharge. The frequency of diagnostic and therapeutic interventions was recorded daily. RESULTS: Data for 1036 patients (mean age 53 years old, 73% female) were analyzed. The most frequent diagnostic categories were musculoskeletal disorders (30%) and neurologic disorders (26%). Therapeutic effects were shown in various outcome measures such as reduced intensity of complaints, improved quality of life, increased satisfaction in lifestyle areas, and fewer days off work. In 6.5% of the subjects, adverse events (mostly of minor severity) were recorded. CONCLUSIONS: Quality profiles can serve as a basic tool for evaluating provider quality when the results are compared with either a predefined standard or with profiles of other providers who are offering similar medical services.