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Content and distribution of discursive space in consultations between patients with atrial fibrillation and healthcare professionals.

https://arctichealth.org/en/permalink/ahliterature126763
Source
Eur J Cardiovasc Nurs. 2013 Feb;12(1):47-55
Publication Type
Article
Date
Feb-2013
Author
Eleni Siouta
Anders Broström
Berith Hedberg
Author Affiliation
Department of Nursing Science, School of Health Sciences, Jönköping University, Sweden. eleni.siouta@hhj.hj.se
Source
Eur J Cardiovasc Nurs. 2013 Feb;12(1):47-55
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Atrial Fibrillation - diagnosis - therapy
Attitude of Health Personnel
Communication
Databases, Factual
Female
Health Personnel - organization & administration
Humans
Male
Middle Aged
Nurse-Patient Relations
Patient Care Team - organization & administration
Physician-Patient Relations
Professional-Patient Relations
Quality Control
Questionnaires
Referral and Consultation - standards - trends
Sweden
Videotape Recording
Abstract
To describe (i) the topics participants talk about, (ii) the use of discursive space in consultations between patients with atrial fibrillation (AF) and their nurses and physicians, and (iii) the frequencies of the ways the patients, nurses and physicians introduce the topics.
Data were collected from 23 videotaped consultations concerning patients with AF as well as physicians and nurses, respectively. To obtain a description of topics discussed, the transcripts were analysed using content analysis. The patterns of dominance for the respective topic and participant were explored from the framework of analysis that treats dominance.
Four topics were used by both nurses and physicians in the consultations. These were 'pathophysiology', 'diagnostic procedures', 'treatment' and 'activity'. In the nurse-patient consultation an additional topic, 'routines related to the physician's responsibilities', emerged. With respect to the number of words and turns, the distribution of the discourse space was almost equal between the nurses and patients and unequal between the physicians and patients. The healthcare professionals initiated the topics more frequently compared to the patients, whereby the medical approach recommended in the guidelines for AF could be recognized. The patients were the dominating initiators in the topic 'activity', which refers to the adaptation of activities in daily life in relation to the AF.
The medical-driven agenda dominates over the patient-driven agenda in consultations between healthcare professional and patients with AF. The patients initiated the conversations when discussing living with AF and were more talkative during conversations in nurse consultations.
PubMed ID
22357787 View in PubMed
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Outcome after 7 years of carotid artery stenting and endarterectomy in Sweden - single centre and national results.

https://arctichealth.org/en/permalink/ahliterature126895
Source
Eur J Vasc Endovasc Surg. 2012 May;43(5):499-503
Publication Type
Article
Date
May-2012
Author
D. Lindström
M. Jonsson
J. Formgren
M. Delle
S. Rosfors
P. Gillgren
Author Affiliation
Department of Vascular Surgery, Karolinska University Hospital, 17176 Stockholm, Sweden. David.lindstrom@ki.se
Source
Eur J Vasc Endovasc Surg. 2012 May;43(5):499-503
Date
May-2012
Language
English
Publication Type
Article
Keywords
Aged
Carotid Artery, Internal - surgery
Carotid Stenosis - diagnosis - therapy
Endarterectomy, Carotid
Female
Humans
Male
Middle Aged
Prosthesis Implantation
Quality Control
Registries
Retrospective Studies
Stents
Stroke
Sweden
Treatment Outcome
Abstract
The aim was internal vascular centre quality-control measures to compare single-centre results with the national perspective, as well as analysing the Swedish results from carotid artery stenting (CAS) and comparing a relatively high-volume single centre with the Swedish Vascular Registry (Swedvasc) data. The second aim was to compare CAS and carotid artery endarterectomy (CEA) outcomes for the same 7-year period.
Retrospective review of a single high-volume centre (Södersjukhuset (SÖS)) (approximately 30 CAS year(-1) approximately 90 CEA year(-1)) versus Swedvasc National data.
All consecutive selective patients treated with CAS at SÖS for a stenosis of the internal carotid artery (n = 208) or CEA (n = 552) between 2004 and 2011 were compared with all patients in Swedvasc registered for CAS (n = 258) and CEA (n = 6474). Primary outcome was 30-day frequency of stroke or death. Secondary outcome was stroke/death/acute myocardial infarction (AMI).
The 30-day frequency of any stroke or death after CAS at SÖS compared to the national data was 2.9% and 7.4%, respectively (P = 0.04). The 30-day AMI/stroke/death frequency was 3.4% and 9.5%, respectively (P = 0.01). After CEA during the same time period, the Swedvasc national data had a 4.4% frequency of 30-day stroke and death and 5.8% for AMI/stroke/death.
CAS is not as safe as CEA from a national perspective but our results indicate that a single centre can achieve acceptable results with CAS.
Notes
Comment In: Eur J Vasc Endovasc Surg. 2012 May;43(5):504-522406238
PubMed ID
22342694 View in PubMed
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Quality control of flow cytometry data analysis for evaluation of minimal residual disease in bone marrow from acute leukemia patients during treatment.

https://arctichealth.org/en/permalink/ahliterature94535
Source
J Pediatr Hematol Oncol. 2009 Jun;31(6):406-15
Publication Type
Article
Date
Jun-2009
Author
Björklund Elisabet
Matinlauri Irma
Tierens Anne
Axelsson Susanne
Forestier Erik
Jacobsson Stefan
Ahlberg Asa Jeppsson
Kauric Goran
Mäntymaa Pentti
Osnes Liv
Penttilä Tarja-Leena
Marquart Hanne
Savolainen Eeva-Riitta
Siitonen Sanna
Torikka Kerstin
Mazur Joanna
Porwit Anna
Author Affiliation
Department of Pathology and Cytology, Karolinska University Hospital, Solna, Karolinska Institute, Stockholm SE 171 76, Sweden. elisabet.bjorklund@karolinska.se
Source
J Pediatr Hematol Oncol. 2009 Jun;31(6):406-15
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Bone Marrow - pathology
Bone Marrow Examination - standards
Child
Child, Preschool
Female
Flow Cytometry - standards
Humans
Male
Medical Oncology - standards
Middle Aged
Neoplasm, Residual - diagnosis
Pathology, Clinical - standards
Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis
Quality Control
Abstract
Low levels of leukemia cells in the bone marrow, minimal residual disease (MRD), are considered to be a powerful indicator of treatment response in acute lymphatic leukemia (ALL). A Nordic quality assurance program, aimed on standardization of the flow cytometry MRD analysis, has been established before implementation of MRD at cutoff level 10 as one of stratifying parameters in next Nordic Society of Pediatric Hematology and Oncology (NOPHO) treatment program for ALL. In 4 quality control (QC) rounds 15 laboratories determined the MRD levels in 48 follow-up samples from 12 ALL patients treated according to NOPHO 2000. Analysis procedures were standardized. For each QC round a compact disc containing data in list-mode files was sent out and results were submitted to a central laboratory. At cutoff level 10, which will be applied for clinical decisions, laboratories obtained a high concordance (91.6%). If cutoff level 10 was applied, the concordance would be lower (85.3%). The continuing standardization resulted in better concordance in QC3 and QC4 compared with QC1 and QC2. The concordance was higher in precursor B as compared with T-cell ALL. We conclude that after standardization, flow cytometry MRD detection can be reliably applied in international, multicenter treatment protocols.
PubMed ID
19648789 View in PubMed
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Outcomes following the implementation of a quality control campaign to decrease sternal wound infections after coronary artery by-pass grafting.

https://arctichealth.org/en/permalink/ahliterature274412
Source
BMC Cardiovasc Disord. 2015;15:154
Publication Type
Article
Date
2015
Author
Rickard P F Lindblom
Birgitta Lytsy
Camilla Sandström
Nadjira Ligata
Beata Larsson
Ulrika Ransjö
Christine Leo Swenne
Source
BMC Cardiovasc Disord. 2015;15:154
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Coronary Artery Bypass - adverse effects - standards
Female
Health Care Surveys
Hospitals, University
Humans
Male
Middle Aged
Program Evaluation
Quality Control
Quality Improvement - standards
Quality Indicators, Health Care - standards
Retrospective Studies
Risk assessment
Risk factors
Sternotomy - adverse effects - standards
Surgical Wound Infection - diagnosis - microbiology - prevention & control
Surveys and Questionnaires
Sweden
Time Factors
Treatment Outcome
Abstract
Coronary artery by-pass grafting (CABG) remains the optimal strategy in achieving complete revascularization in patients with complex coronary artery disease. However, sternal wound infections (SWI), especially deep SWI are potentially severe complications to the surgery. At the department of cardiothoracic surgery in Uppsala University Hospital a gradual increase in all types of SWI occurred, which peaked in 2009. This prompted an in-depth revision of the whole surgical process. To monitor the frequency of post-operative infections all patients receive a questionnaire that enquires whether any treatment for wound infection has been carried out.
All patients operated with isolated CABG between start of 2006 and end of 2012 were included in the study. 1515 of 1642 patients answered and returned the questionnaire (92.3 %). The study period is divided into the time before the intervention program was implemented (2006-early 2010) and the time after the intervention (early 2010- end 2012). To assess whether potential differences in frequency of SWI were a consequence of change in the characteristics of the patient population rather than an effect of the intervention a retrospective assessment of medical records was performed, where multiple of the most known risk factors for developing SWI were studied.
We noticed a clear decrease in the frequency of SWI after the intervention. This was not a consequence of a healthier population.
Our results from implementing the intervention program are positive in that they reduce the number of SWI. As several changes in the perioperative care were introduced simultaneously we cannot deduce which is the most effective.
Notes
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PubMed ID
26577692 View in PubMed
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Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian rural community.

https://arctichealth.org/en/permalink/ahliterature105552
Source
Scand J Trauma Resusc Emerg Med. 2013;21:89
Publication Type
Article
Date
2013
Author
Sverre Rørtveit
Eivind Meland
Steinar Hunskaar
Author Affiliation
Austevoll Municipality Health Services, Bekkjarvik, 5399, Norway. sverre.rortveit@aknett.net.
Source
Scand J Trauma Resusc Emerg Med. 2013;21:89
Date
2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Confidence Intervals
Emergency medical services
Female
General practice
Hospitals, Rural
Humans
Infant
Male
Middle Aged
Norway
Odds Ratio
Physician's Practice Patterns
Quality Control
Questionnaires
Triage - classification
Young Adult
Abstract
Priority grade assessment according to urgency level of the patients (triage) is considered vital in emergency medicine casualties. Little is known of the experiences of pre-hospital emergency medicine triage performed by General Practitioners (GPs) in the community. In this study we bring such experiences from a Norwegian island community, with special emphasis on over- and undertriage.
In the island municipality of Austevoll, Western Norway, where the GPs and the ambulance services both take part in all medical emergency cases, all these cases were recorded during a 2-year period (2005-2007). We compared the triage of the patients at the stage of the telephone reception of the incident, and the subsequent revision of the triage at the first personal examination of the patient.
236 emergency medical events were recorded, comprising 240 patients. Of these, 42% were downgraded between the stages (i.e. initially overtriaged), 11% were upgraded (i.e. initially undertriaged) and 47% remained in unchanged priority group. Of the diagnostic groups, acute abdominal cases had the highest probability of being upgraded between stages, while the aggregated diagnostic group of syncopes, seizures, intoxications and traumas had the highest probability of being downgraded. The principal reason for upgrading was lack of necessary information at the stage of call. In a minority of cases the upgrading was due to real patient deterioration between stages.
In pre-hospital triage of emergency patients, downgrading happens between notification of events and actual patient examination in a substantial proportion. Upgradings of cases are considerably fewer, but the potential serious implications of upgrading warrants individual scrutiny of such cases.
Notes
Cites: Tidsskr Nor Laegeforen. 2013 Sep 3;133(16):1683-424005692
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Cites: Tidsskr Nor Laegeforen. 2009 Apr 16;129(8):735-719373297
PubMed ID
24354953 View in PubMed
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Standard operating procedure changed pre-hospital critical care anaesthesiologists' behaviour: a quality control study.

https://arctichealth.org/en/permalink/ahliterature105812
Source
Scand J Trauma Resusc Emerg Med. 2013;21:84
Publication Type
Article
Date
2013
Author
Leif Rognås
Troels Martin Hansen
Hans Kirkegaard
Else Tønnesen
Author Affiliation
Department of research and development, Norwegian Air Ambulance Foundation, P,O, Pox 94, Drøbak, 1441 Norway. leifrogn@rm.dk.
Source
Scand J Trauma Resusc Emerg Med. 2013;21:84
Date
2013
Language
English
Publication Type
Article
Keywords
Air Ambulances
Anesthesiology - methods - standards
Brain Injuries
Clinical Protocols
Critical Care - standards
Denmark
Emergency Medical Services - methods - standards
Humans
Physician's Practice Patterns
Practice Guidelines as Topic
Prospective Studies
Quality Control
Quality Indicators, Health Care
Respiration, Artificial - methods
Ventilators, Mechanical - utilization
Abstract
The ability of standard operating procedures to improve pre-hospital critical care by changing pre-hospital physician behaviour is uncertain. We report data from a prospective quality control study of the effect on pre-hospital critical care anaesthesiologists' behaviour of implementing a standard operating procedure for pre-hospital controlled ventilation.
Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region prospectively registered pre-hospital advanced airway-management data according to the Utstein-style template. We collected pre-intervention data from February 1st 2011 to January 31st 2012, implemented the standard operating procedure on February 1st 2012 and collected post intervention data from February 1st 2012 until October 31st 2012. We included transported patients of all ages in need of controlled ventilation treated with pre-hospital endotracheal intubation or the insertion of a supraglottic airways device. The objective was to evaluate whether the development and implementation of a standard operating procedure for controlled ventilation during transport could change pre-hospital critical care anaesthesiologists' behaviour and thereby increase the use of automated ventilators in these patients.
The implementation of a standard operating procedure increased the overall prevalence of automated ventilator use in transported patients in need of controlled ventilation from 0.40 (0.34-0.47) to 0.74 (0.69-0.80) with a prevalence ratio of 1.85 (1.57-2.19) (p?=?0.00). The prevalence of automated ventilator use in transported traumatic brain injury patients in need of controlled ventilation increased from 0.44 (0.26-0.62) to 0.85 (0.62-0.97) with a prevalence ratio of 1.94 (1.26-3.0) (p?=?0.0039). The prevalence of automated ventilator use in patients transported after return of spontaneous circulation following pre-hospital cardiac arrest increased from 0.39 (0.26-0.48) to 0.69 (0.58-0.78) with a prevalence ratio of 1.79 (1.36-2.35) (p?=?0.00).
We have shown that the implementation of a standard operating procedure for pre-hospital controlled ventilation can significantly change pre-hospital critical care anaesthesiologists' behaviour.
Notes
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PubMed ID
24308781 View in PubMed
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Developing templates for uniform data documentation and reporting in critical care using a modified nominal group technique.

https://arctichealth.org/en/permalink/ahliterature105961
Source
Scand J Trauma Resusc Emerg Med. 2013;21:80
Publication Type
Article
Date
2013
Author
Hans Morten Lossius
Andreas J Krüger
Kjetil Gorseth Ringdal
Stephen J M Sollid
David J Lockey
Author Affiliation
Department of Research and Development, Norwegian Air Ambulance Foundation, Holterveien 24, Drøbak 1441, Norway. hans.morten.lossius@snla.no.
Source
Scand J Trauma Resusc Emerg Med. 2013;21:80
Date
2013
Language
English
Publication Type
Article
Keywords
Checklist
Consensus
Critical Care
Delphi Technique
Documentation - standards
Group Processes
Humans
Norway
Quality Control
Wounds and Injuries
Abstract
Clinical practice in trauma and critical care is predominantly derived from quantitative observational cohort studies based on data retrospectively collected from medical records. Such data create uncontrolled bias and influence external and internal validity, thereby hindering systematic reviews. Templates or standards for uniform documenting and scientific reporting may result in high quality and internationally standardised data being collected on a regular basis, enhance large international multi-centre studies, and increase the quality of evidence. Templates or standards may be developed using multidisciplinary expert panel consensus methods.We present three consensus processes aimed at developing templates for documenting and scientific reporting. We discuss the advantages, limitations, and possible future improvements of our method.
The template preparation was based on expert panel consensus derived through a modified nominal group technique (NGT) method that combined the traditional Delphi method with the traditional NGT method in a four-step process.
Standard templates for documenting and scientific reporting were developed for major trauma, pre-hospital advanced airway handling, and physician-staffed pre-hospital EMS. All templates were published in scientific journals.
Our modified NGT consensus method can successfully be used to establish templates for reporting trauma and critical care data. When used in a structured manner, the method uses recognised experts to achieve consensus, but based on our experiences, we recommend the consensus process to be followed by feasibility, reliability, and validity testing.
PubMed ID
24279612 View in PubMed
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Visualization of regulations to support design and quality control--a long-term study.

https://arctichealth.org/en/permalink/ahliterature259266
Source
Work. 2012;41 Suppl 1:2683-5
Publication Type
Article
Date
2012
Author
Mikael Blomé
Source
Work. 2012;41 Suppl 1:2683-5
Date
2012
Language
English
Publication Type
Article
Keywords
Data Display
Human Engineering
Humans
Interior Design and Furnishings - legislation & jurisprudence - standards
Manufacturing Industry
Quality Control
Sweden
Time Factors
Abstract
The aim of the study was to visualize design regulations of furniture by means of interactive technology based on earlier studies and practical examples. The usage of the visualized regulations was evaluated on two occasions: at the start when the first set of regulations was presented, and after six years of usage of all regulations. The visualized regulations were the result of a design process involving experts and potential users in collaboration with IKEA of Sweden AB. The evaluations by the different users showed a very positive response to using visualized regulations. The participative approach, combining expertise in specific regulations with visualization of guidelines, resulted in clear presentations of important regulations, and great attitudes among the users. These kinds of visualizations have proved to be applicable in a variety of product areas at IKEA, with a potential for further dissemination. It is likely that the approaches to design and visualized regulations in this case study could function in other branches.
PubMed ID
22317126 View in PubMed
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WebRehab: a Swedish database for quality control in rehabilitation.

https://arctichealth.org/en/permalink/ahliterature259315
Source
J Rehabil Med. 2014 Nov 4;46(10):958-62
Publication Type
Article
Date
Nov-4-2014
Author
Katharina S Sunnerhagen
Ulla-Britt Flansbjer
Marianne Lannsjö
Anna Tölli
Asa Lundgren-Nilsson
Source
J Rehabil Med. 2014 Nov 4;46(10):958-62
Date
Nov-4-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Databases, Factual
Disabled Persons - rehabilitation
Female
Humans
Internet
Male
Middle Aged
Quality Control
Registries
Rehabilitation - standards
Sweden
Abstract
The healthcare sector needs to deliver evidence-based care and be cost-effective. This can be monitored in part via a national quality registry containing individualized data concerning patient problems, medical interventions, outcomes of treatment, and patient-reported outcomes. With this aim, WebRehab Sweden was launched in 1997 and has been available online since 2007. The aim of this paper is to discuss the design, some results, and possible use of such a registry.
Data entered into the registry online since 2007 were used in this paper. The registry contains information from 7,458 patients. Data from the first 3 years were used to show differences between genders and among diagnostic groups. Non-parametric statistics were used to analyse the differences between groups.
The registry coverage of the country is 95%, and completeness is 81%. Data from hospitals/units have been accessible to the general public since 2009, but no data from individuals can be accessed. Length of stay has varied over the years, becoming significantly shorter between 2007 and 2012.
A quality registry presents an opportunity to improve rehabilitation processes at participating units, provides data for use in benchmarking between units, and enables hospital management to utilize resources wisely.
PubMed ID
25296702 View in PubMed
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628 records – page 1 of 63.