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Quality Indicators And Healthcare

Quality Indicators And Healthcare. A First Step To The Evaluation Of A Hospital’s Performance. Introdução à Medicina 2008/2009. Authors. Ana Cristina Pereira Ana Teresa Carapenha Ana Rita Oliveira André Vinha Catarina Vieira Eduardo Freitas João Rebelo Mariana Oliveira

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Quality Indicators And Healthcare

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  1. Quality Indicators AndHealthcare A FirstStep To TheEvaluationOf A Hospital’s Performance Introdução à Medicina 2008/2009 Authors Ana Cristina Pereira Ana Teresa Carapenha Ana Rita Oliveira André Vinha Catarina Vieira Eduardo Freitas João Rebelo Mariana Oliveira Marli Cruz Nuno Ribeiro Paulo Guedes Victoriano Costa

  2. QualityOfHealthcare Indicators Performance measuring The indicators are the source of information to evaluate the performance of a hospital. KIRKMAN, Jamie John, Bouamra, Omar , 2008. Introdução à Medicina - Turma 10

  3. QualityOfHealthcare Indicators Usefulinformation Posterior performance measurements Eddy, David M., 1998 Introdução à Medicina - Turma 10

  4. ResearchQuestionandMainAim How did quality and performance indicators evolve through the years in a central hospital? Our main objective is to calculate these indicators concerning different variables and to have a perspective of the performance of the hospital in case. Used data: episodes in a central hospital, between 1999 and 2008. Introdução à Medicina - Turma 10

  5. SpecificAims Outpatientepisodes Mortality Evaluatethecarequality Analyzethequalityofthedata Quantifythehospital’sactivity Postponedsurgeries Outpatientsurgery Principal diagnosis Surgicalcomplications Childbirthofcaesarianoperation Lengthofstay Lengthofstay Introdução à Medicina - Turma 10

  6. Methods SPSS (Statistical Package for the Social Sciences) Provider of predictive analytics software and solutions. (*) SPSS Indicators’ calculation Global values Others According to DRGs According to gender According to age group (*) SPSS: The Predictive Analytics Company: http://www.spss.com/corpinfo/?source=homepage&hpzone=nav_bar Introdução à Medicina - Turma 10

  7. Methods DRGs “A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay.” (*) ICD-9-CM “ICD-9-CM is the official system of assigning codes to diagnoses and procedures associated with hospital utilization in the United States.” (**) INE “The entity responsible for ensuring the production and dissemination of official statistical information.” (***) (*) MeSh definition (**) Classifications of Diseases and Functioning & Disability: http://www.cdc.gov/nchs/about/otheract/icd9/abticd9.htm (***) Statistics Portugal: http://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_cont_inst&ine_smenu.boui=13918434&INST=53864&xlang=en Introdução à Medicina - Turma 10

  8. ObtainedResults (****) CC: complications and commorbilities. (HCUP -3 Nationwide Inpatient Sample for 1994: Diagnosis-Related Groups: http://www.hcup-us.ahrq.gov/reports/natstats/94drga.htm#146) Introdução à Medicina - Turma 10

  9. ObtainedResults Introdução à Medicina - Turma 10

  10. ObtainedResults Introdução à Medicina - Turma 10

  11. ObtainedResults Introdução à Medicina - Turma 10

  12. ObtainedResults Introdução à Medicina - Turma 10

  13. ObtainedResults Introdução à Medicina - Turma 10

  14. ObtainedResults Statistics Portugal: http://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_cont_inst&ine_smenu.boui=13918434&INST=53864&xlang=en Introdução à Medicina - Turma 10

  15. ObtainedResults Introdução à Medicina - Turma 10

  16. ObtainedResults Introdução à Medicina - Turma 10

  17. ObtainedResults Introdução à Medicina - Turma 10

  18. ObtainedResults Introdução à Medicina - Turma 10

  19. References • Reinhardt, Uwe E.: Quality in consumer-driven health systems. International Journal for Health Care. 1998; 10(5) • Bentes, Margarida; Berardo, Ana; Matias, Alberto: XVII Congresso da União Europeia de Gestores Hospitalares. 1999. • Hsieh, Mei-o; Kagle, Jill Doner: Understanding patient satisfaction and dissatisfaction with health care. Health Soc Work. 1991 Nov;16(4):281-90. • Gardner, Karen L.; Sibthorpe, Beverly;  Longstaff, Duncan: National quality and performance system for divisions of general practice: early reflections on a system under development. 2007. • Eddy, David M.: Performance measurements: problems and solutions in Health Affairs. Vol.17. 4, 1998. • Geraedts, Max; Schwartze, David; Molzahn,Tanja: Hospital quality reports in Germany: patient and physician opinion of the reported quality indicators. BMC HealthServRes.; 2007 Sep 28; 7-157. • Bentes, Margarida; Gonçalves, Maria da Luz; Tranquada, Suzete; Urbano, João: A utilização dos DGH’s como instrumento de financiamento hospitalar. Gestão Hospital, 33-42. • National Library of Medicine. • Available from: http://www.acss.min-saude.pt. • Briz, Teodoro; Dias, Carlos Matias; Freitas, Mário: Indicadores de saúde: uma visão de Saúde Pública, com interesse em Medicina Geral e Familiar. Revista Portuguesa Clínica Geral 2007;23:439-50 • Ribeiro, Nuno. Administração pública. TOC. 2000/08 • Dimick, Justin B.; Welch, H. Gilbert; Birkmeyer, John D.: Surgical mortality as an indicator of hospital quality: the problem with small sample size. JAMA. 2004 Aug 18;292(7):847-51. • Endahl, Lars A.; Utzon, Jan: Will publication of quality indicators in the health service improve the quality? International experiences and Danish perspectives.UgeskrLaeger. 2002 Sep 16;164(38):4380-4. • National report on health sector performance indicators 2003. Canberra: Australian Institute of Health and Welfare; 2004. Introdução à Medicina - Turma 10

  20. References • Ravaud, P., Giraudeau, Bruno; Roux, P.M., Durieux, P.: Are mortality indicators acceptable indicators for the quality of health care?. Presse Med. 1999 Oct 2;28(29):1604-9. • Brooks, Robert; Brown, Steven L.; Chukmaitov,Askar S.; Menachemi,Nir; Saunders, Charles; Tang,Anqi: Is there a relationship between physician and facility volumes of ambulatory procedures and patient outcomes? J Ambul Care Manage. 2008 Oct-Dec;31(4):354-69. • Merrill, Douglas: Management of outcomes in the ambulatory surgery center: the role of standard work and evidence-based medicine. CurrOpinAnaesthesiol. 2008 Dec;21(6):743-7. • MOORE, Dan H.; SAWAYA, George F.; Hopkins, Linda M.; NOAH, M.S.; LAROS, Russell K.; ESAKOFF, T.: Outcomes associated with cesarean section versus vaginal breech delivery at a university hospital. J Perinatol. 2007 Mar;27(3):141-6. Epub 2006 Oct 12. • URIEL, Zanon. Qualidade da assistência médico-hospitalar: conceito e avaliação de indicadores. 2000 Jul-Set RAS. Vol. 2, Nº 8. Available from:  http://www.cqh.org.br/files/ARTIGORAS08.pdf. • SPSS: The Predictive Analytics Company. • Available from: http://www.spss.com/corpinfo/?source=homepage&hpzone=nav_bar. • MURPHY, Mark E.; NOETSCHER, Cheryl M.: Reducing hospital inpatient lengths of stay. J Nurs Care Qual. 1999 Nov;Spec No:40-54. • MIRZA, Fadi G.; WYLIE, Blair J.: Cesarean delivery in the developing world. ClinPerinatol. 2008 Sep;35(3):571-82, xii. • SHEARER, E.L.: Cesarean section: medical benefits and costs. Soc Sci Med. 1993 Nov;37(10):1223-31. • LEITE, Sofia. População presente e população residente segundo o sexo e idades através dos censos.Available from: • http://www.ine.pt/ngt_server/attachfileu.jsp?look_parentBoui=107136&att_display=n&att_download=y • THOMAS, J. William; GUIRE, Kenneth E.; HORVAT, Gary G.:Is patient length of stay related to quality of care? Hosp Health Serv Adm. 1997 Winter;42(4):489-507. • JIMÉNEZ, Rosa; LÓPEZ, Libia; DOMINGUEZ, Daniel; FARIÑAS, Humberto: Difference between observed and predicted length of stay as an indicator of inpatient care inefficiency. Int J Qual Health Care. 1999 Oct;11(5):375-84. Introdução à Medicina - Turma 10

  21. References • MARCH, S.; SWART, E.; ROBRA, B.: Patient satisfaction with outpatient/short stay operations in a practice clinic. Gesundheitswesen. 2006 Jun;68(6):376-82. • COYLE, T.T.; HELFRICK, J.F.; GONZALEZ, M.L.; ANDRESEN, R.V., PERROTT, D.H.: Office-based ambulatory anesthesia: Factors that influence patient satisfaction or dissatisfaction with deep sedation/general anesthesia. J Oral Maxillofac Surg. 2005 Feb;63(2):163-72. • GICHANGI, P.; APERS, L.; TEMMERMAN, M: Rate of caesarean section as a process indicator of safe motherhood programmes: the case of Kenya. J Health PopulNutr. 2001 Jun;19(2):52-8. • Inpatient quality indicators overview.Available from:http://www.qualityindicators.ahrq.gov/iqi_overview.htm • COPNELL, Beverley; HAGGER, Virginia; WILSON, Sally G.; EVANS, Susan M.; SPRIVULIS, Peter C.; CAMERON, Peter A.: Measuring the quality of hospital care: an inventory of indicators. Intern Med J. 2009 Mar 23. • HEIJINK, Richard; KOOLMAN, Xander; PIETER, Daniel; VAN DER VEEN, André; JARMAN, Brian; WESTERT, Gert: Measuring and explaining mortality in Dutch hospitals; the hospital standardized mortality rate between 2003 and 2005. BMC Health Serv Res. 2008 Apr 3;8:73. • CAMERON, P.A.; GABBE, B.J.; MCNEIL, J.J.: The importance of quality of survival as an outcome measure for an integrated trauma system. Injury. 2006 Dec;37(12):1178-84. Epub 2006 Nov 7. • JAIPAUL, C.K.; ROSENTHAL, G.E.: Do hospitals with lower mortality have higher patient satisfaction? A regional analysis of patients with medical diagnoses. Am J Med Qual. 2003 Mar-Apr;18(2):59-65. • KAVANAGH, Patricia L.; ADAMS, William G.; WANG, C. Jason: Quality indicators and quality assessment in child health. Arch Dis Child. 2009 Mar 22. • BAARS, Irma J.; EVERS, Silvia M.; ARNTZ, Arnoud; VAN MERODE, Godefridus: Performance measurement in mental health care: present situation and future possibilities. Int J Health Plann Manage. 2009 Feb 11. • HCUP-3 Nationwide Inpatient Sample for 1994: Diagnosis-Related Groups. Available from: http://www.hcup-us.ahrq.gov/reports/natstats/94drga.htm#146. Introdução à Medicina - Turma 10

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