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30-Day Survival Probabilities as a Quality Indicator for Norwegian Hospitals: Data Management and Analysis.

https://arctichealth.org/en/permalink/ahliterature273361
Source
PLoS One. 2015;10(9):e0136547
Publication Type
Article
Date
2015
Author
Sahar Hassani
Anja Schou Lindman
Doris Tove Kristoffersen
Oliver Tomic
Jon Helgeland
Source
PLoS One. 2015;10(9):e0136547
Date
2015
Language
English
Publication Type
Article
Keywords
Comorbidity
Diagnosis-Related Groups
Episode of Care
Hospital Mortality
Hospital records
Hospitals - standards - statistics & numerical data
Humans
Length of Stay
Norway - epidemiology
Patient Admission - statistics & numerical data
Patient Discharge - statistics & numerical data
Patient transfer
Probability
Quality Improvement
Quality Indicators, Health Care
Survival Analysis
Abstract
The Norwegian Knowledge Centre for the Health Services (NOKC) reports 30-day survival as a quality indicator for Norwegian hospitals. The indicators have been published annually since 2011 on the website of the Norwegian Directorate of Health (www.helsenorge.no), as part of the Norwegian Quality Indicator System authorized by the Ministry of Health. Openness regarding calculation of quality indicators is important, as it provides the opportunity to critically review and discuss the method. The purpose of this article is to describe the data collection, data pre-processing, and data analyses, as carried out by NOKC, for the calculation of 30-day risk-adjusted survival probability as a quality indicator.
Three diagnosis-specific 30-day survival indicators (first time acute myocardial infarction (AMI), stroke and hip fracture) are estimated based on all-cause deaths, occurring in-hospital or out-of-hospital, within 30 days counting from the first day of hospitalization. Furthermore, a hospital-wide (i.e. overall) 30-day survival indicator is calculated. Patient administrative data from all Norwegian hospitals and information from the Norwegian Population Register are retrieved annually, and linked to datasets for previous years. The outcome (alive/death within 30 days) is attributed to every hospital by the fraction of time spent in each hospital. A logistic regression followed by a hierarchical Bayesian analysis is used for the estimation of risk-adjusted survival probabilities. A multiple testing procedure with a false discovery rate of 5% is used to identify hospitals, hospital trusts and regional health authorities with significantly higher/lower survival than the reference. In addition, estimated risk-adjusted survival probabilities are published per hospital, hospital trust and regional health authority. The variation in risk-adjusted survival probabilities across hospitals for AMI shows a decreasing trend over time: estimated survival probabilities for AMI in 2011 varied from 80.6% (in the hospital with lowest estimated survival) to 91.7% (in the hospital with highest estimated survival), whereas it ranged from 83.8% to 91.2% in 2013.
Since 2011, several hospitals and hospital trusts have initiated quality improvement projects, and some of the hospitals have improved the survival over these years. Public reporting of survival/mortality indicators are increasingly being used as quality measures of health care systems. Openness regarding the methods used to calculate the indicators are important, as it provides the opportunity of critically reviewing and discussing the methods in the literature. In this way, the methods employed for establishing the indicators may be improved.
Notes
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PubMed ID
26352600 View in PubMed
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[Access to case records at Aalborg Psychiatric Hospital 1 March 1987-29 February 1988. A prospective study]

https://arctichealth.org/en/permalink/ahliterature12182
Source
Ugeskr Laeger. 1990 May 21;152(21):1528-31
Publication Type
Article
Date
May-21-1990
Author
E. Høyer
I. Kattrup
P B Christensen
Author Affiliation
Aalborg Psykiatriske Sygehus, afsnit R og S.
Source
Ugeskr Laeger. 1990 May 21;152(21):1528-31
Date
May-21-1990
Language
Danish
Publication Type
Article
Keywords
Adult
Aged
Denmark
English Abstract
Hospital Records - legislation & jurisprudence
Hospitals, Psychiatric
Humans
Legislation, Medical - trends
Male
Mental Disorders - diagnosis
Middle Aged
Patient Advocacy - legislation & jurisprudence
Prospective Studies
Psychiatry - legislation & jurisprudence
Abstract
The purpose of the investigation was to examine the utilization of the Danish legislation concerning access to case records by means of a prospective registration and questionnaire. During the investigation-period (1.3.1987-29.02.1988) 50 requests were made of which only one was refused for a limited period. The patients requesting to read their records differed from the total population of hospitalized patients as regards diagnosis as significantly more schizofrenic and fewer patients with diagnoses of drug abuse, were found. One of the 32 patients who actually read their records became more psychotic afterwards and two patients stated that they had become agitated. However, 15 patients felt calmer and 29 patients (90.6%) stated that the purpose of requesting access to their records had been fulfilled. The overall impression is that the law, which came into effect 1.1.1987, has functioned adequately although a more restrictive attitude would perhaps have reduced the negative influence on the psychotic conditions observed in three patients.
PubMed ID
2360272 View in PubMed
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[Access to case records at the County Hospital in Vordingborg]

https://arctichealth.org/en/permalink/ahliterature37684
Source
Ugeskr Laeger. 1990 May 21;152(21):1531-3
Publication Type
Article
Date
May-21-1990
Author
H. Raben
H M Pedersen
L. Pedersen
Author Affiliation
Amtshospitalet i Vordingborg.
Source
Ugeskr Laeger. 1990 May 21;152(21):1531-3
Date
May-21-1990
Language
Danish
Publication Type
Article
Keywords
Adolescent
Adult
Child
Child, Preschool
Denmark
English Abstract
Female
Hospital Records - legislation & jurisprudence
Hospitals, Psychiatric
Humans
Infant
Legislation, Medical - trends
Male
Mental Disorders - diagnosis
Middle Aged
Patient Advocacy - legislation & jurisprudence
Psychiatry - legislation & jurisprudence
Abstract
During 1987, all requests for access to case records at the Psychiatric Hospital in Vordingborg were registered prospectively. Fifty-nine patients made a total of 69 requests for access to case records. The total time used by the staff in connection with the requests was 51 hours and 47 minutes. Of all the patients admitted to the hospital in 1987 only 3.7% asked for access to case records. No serious problems in relation to this were registered. There was a significant tendency for the younger patients, the patients with non-psychotic disorders, and especially patients with borderline disorders to ask for access to their records more frequently.
PubMed ID
2360273 View in PubMed
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[Access to case records in department for child and adolescent psychiatry]

https://arctichealth.org/en/permalink/ahliterature38125
Source
Ugeskr Laeger. 1989 May 29;151(22):1392-4
Publication Type
Article
Date
May-29-1989
Author
B. Leroy
C. Schou
Source
Ugeskr Laeger. 1989 May 29;151(22):1392-4
Date
May-29-1989
Language
Danish
Publication Type
Article
Keywords
Adolescent
Adolescent Psychiatry
Child
Child Psychiatry
Child, Preschool
Denmark
English Abstract
Hospital records
Humans
Psychiatric Department, Hospital
Abstract
The object of this investigation was registration of all requests for access to case records in 1987 in all departments for child and adolescent psychiatry in Denmark. A total of 34 requests were made concerning child psychiatric departments and 55 concerning departments for adolescent psychiatry. This corresponds to requests for access to case records in 0.8% of all patients admitted to departments of child psychiatry, and also 0.8% of the outpatients. In the departments for adolescent psychiatry, access to the case records was desired concerning 16.5% of the hospitalized adolescents. No complaints have been made concerning access to the case records and it is concluded that the new Danish law functions satisfactorily also where parents were concerned, where the possibility of providing limited insight for adolescents or parents may be of value. The significance of introduction of a period of limitation for access to case records in departments for child and adolescent psychiatry is emphasized.
PubMed ID
2734941 View in PubMed
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[Access to documents. Now patients have the right to see their own records].

https://arctichealth.org/en/permalink/ahliterature235665
Source
Sygeplejersken. 1987 Jan 28;87(5):12-4
Publication Type
Article
Date
Jan-28-1987
Author
K K Larsen
Source
Sygeplejersken. 1987 Jan 28;87(5):12-4
Date
Jan-28-1987
Language
Danish
Publication Type
Article
Keywords
Denmark
Hospital records
Humans
Medical Records
Patient Advocacy
Records as Topic
PubMed ID
3647649 View in PubMed
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Accidental cold-related injury leading to hospitalization in northern Sweden: an eight-year retrospective analysis.

https://arctichealth.org/en/permalink/ahliterature257987
Source
Scand J Trauma Resusc Emerg Med. 2014;22:6
Publication Type
Article
Date
2014
Author
Helge Brändström
Göran Johansson
Gordon G Giesbrecht
Karl-Axel Ängquist
Michael F Haney
Author Affiliation
Department of Surgical and Perioperative Sciences, Anesthesia and Intensive Care Medicine, Faculty of Medicine, Umeå University, S-901 85 Umeå, Sweden. helge.brandstrom@vll.se.
Source
Scand J Trauma Resusc Emerg Med. 2014;22:6
Date
2014
Language
English
Publication Type
Article
Keywords
Cold Temperature - adverse effects
Follow-Up Studies
Hospital records
Hospitalization - trends
Humans
Hypothermia - epidemiology - etiology - therapy
Incidence
Retrospective Studies
Rewarming - methods
Sweden - epidemiology
Time Factors
Abstract
Cold injuries are rare but important causes of hospitalization. We aimed to identify the magnitude of cold injury hospitalization, and assess causes, associated factors and treatment routines in a subarctic region.
In this retrospective analysis of hospital records from the 4 northernmost counties in Sweden, cases from 2000-2007 were identified from the hospital registry by diagnosis codes for accidental hypothermia, frostbite, and cold-water drowning. Results were analyzed for pre-hospital site events, clinical events in-hospital, and complications observed with mild (temperature 34.9 - 32°C), moderate (31.9 - 28°C) and severe (
Notes
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PubMed ID
24460844 View in PubMed
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Accuracy of administrative data for assessing outcomes after knee replacement surgery.

https://arctichealth.org/en/permalink/ahliterature209148
Source
J Clin Epidemiol. 1997 Mar;50(3):265-73
Publication Type
Article
Date
Mar-1997
Author
G A Hawker
P C Coyte
J G Wright
J E Paul
C. Bombardier
Author Affiliation
Department of Medicine, Faculty of Medicine, University of Toronto, Ontario, Canada.
Source
J Clin Epidemiol. 1997 Mar;50(3):265-73
Date
Mar-1997
Language
English
Publication Type
Article
Keywords
Comorbidity
Databases, Factual
Hospital records
Humans
Joint Diseases - complications - surgery
Knee Prosthesis - standards - statistics & numerical data
Ontario
Outcome Assessment (Health Care)
Pilot Projects
Postoperative Complications
Registries
Abstract
To assess the accuracy of information in an administrative database (Canadian Institute for Health Information; CIHI) compared with the hospital record for patients undergoing knee replacement (KR).
A stratified random sample of 185 KR recipients from 5 Ontario hospitals were chosen. Their hospital records and corresponding CIHI files were compared to assess percent complete agreement, false negative (FN) and false positive (FP) rates for demographic data, procedures, and diagnoses.
Of 185 records, 175 (95%) were reviewed. Percent complete agreement was greater than 94% for each of patient demographics and procedures (mean FN rates: 0%; mean FP rates: 0-5%). For comorbidities and complications, although mean percent complete agreement was high, and FP rates were low, mean FN rates were 63% for specific comorbid conditions and 70% for organ systems.
High FN rates have been found in documentation of comorbidities and in-hospital complications for CIHI data compared with the hospital record. Under-coding of comorbidities and in-hospital complications has potential implications for researchers using administrative databases.
PubMed ID
9120525 View in PubMed
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Accuracy of hospital discharge data: five alcohol-related diseases.

https://arctichealth.org/en/permalink/ahliterature241386
Source
Drug Alcohol Depend. 1983 Dec;12(4):315-22
Publication Type
Article
Date
Dec-1983
Author
K. Poikolainen
Source
Drug Alcohol Depend. 1983 Dec;12(4):315-22
Date
Dec-1983
Language
English
Publication Type
Article
Keywords
Alcoholic Intoxication - diagnosis
Alcoholism - complications - diagnosis
Female
Finland
Hospital records
Humans
Liver Cirrhosis, Alcoholic - diagnosis
Male
Medical Records
Pancreatitis - etiology
Patient Discharge
Psychoses, Alcoholic - diagnosis
Records as Topic
Abstract
Accuracy of hospital discharge register data was studied by comparing 954 randomly selected abstracts to the respective medical records. The average percentages of agreement were: date of birth 98, date of admission 96, date of discharge 94, area of residence 93, principal diagnosis 91, disposition on discharge 89, marital status 84, third diagnosis 83, second diagnosis 76, social group 74, occupation 60, and source of admission 49. Accuracy of items was not related to alcohol etiology. An analysis of variance indicated that the number of items in agreement varied by both diagnosis and type of hospital.
PubMed ID
6671415 View in PubMed
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Acetaminophen availability increases in Canada with no increase in the incidence of reports of inpatient hospitalizations with acetaminophen overdose and acute liver toxicity.

https://arctichealth.org/en/permalink/ahliterature177413
Source
Am J Ther. 2004 Nov-Dec;11(6):443-52
Publication Type
Article
Author
Mary Jane Prior
Kimberly Cooper
Peter Cummins
Debra Bowen
Author Affiliation
Research and Development, McNeil Consumer and Specialty Pharmaceuticals, Fort Washington, Pennsylvania 19034, USA. mprior@mccus.jnj.com
Source
Am J Ther. 2004 Nov-Dec;11(6):443-52
Language
English
Publication Type
Article
Keywords
Acetaminophen - adverse effects
Adolescent
Adult
Adverse Drug Reaction Reporting Systems - statistics & numerical data
Aged
Analgesics, Non-Narcotic - adverse effects
Canada - epidemiology
Child
Drug Overdose
Drug Utilization - statistics & numerical data
Drug and Narcotic Control - legislation & jurisprudence
Drug-Induced Liver Injury - epidemiology - etiology
Hospital records
Humans
Middle Aged
Abstract
In September 1999, several Canadian provinces had place-of-sale restrictions lifted that had limited the sale of acetaminophen >325 mg and packages >24 tablets (any strength) to pharmacies only. This allowed the sale of all strengths of immediate-release acetaminophen in all package sizes in nonpharmacy locations. This study's purpose was to explore the effect that lifting restrictions on acetaminophen place of sale may have had on reported hospitalizations in Canada related to acetaminophen overdose toxicity. Using hospital discharge data, provinces with no preexisting restrictions on place of sale were compared with those in which restrictions were lifted in September 1999. Cases of reported APAP overdose included ICD-9/9-CM code 965.4, ICD-9 code E850.2, or ICD-9-CM code E850.4. Cases with reported acute liver toxicity included ICD-9/9-CM codes 570, 572.2, 572.4, V42.7, or procedure code 50.5. There were no significant differences between the 1.5-year periods pre- and post-September 1999 in annual incidence rates per 100,000 persons ages >/=12 years of hospitalizations reported with acetaminophen overdose, either overall or limited to those with death as an outcome, or in hospitalization reports with both acetaminophen overdose and acute liver toxicity, either overall (provinces with no restrictions: pre = 0.70, post = 0.80, P = 0.6328; provinces with restrictions lifted in September 1999: pre = 0.49, post = 0.47, P = 0.8649) or limited to those with death as an outcome (provinces with no restrictions: pre = 0.22, post = 0.12, P = 0.3030; provinces with restrictions lifted in September 1999: pre = 0.13, post = 0.09, P = 0.3589). In conclusion, the decision to lift Canadian place-of-sale restrictions increased acetaminophen availability and did not increase the rate of reported hospitalizations related to acetaminophen overdose toxicity.
PubMed ID
15543083 View in PubMed
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202 records – page 1 of 21.