Articles: outcome-assessment-health-care.
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Multicenter Study Comparative Study
Differential case ascertainment in clinical registry versus administrative data and impact on outcomes assessment for pediatric cardiac operations.
Administrative datasets are often used to assess outcomes and quality of pediatric cardiac programs; however their accuracy regarding case ascertainment is unclear. We linked patient data (2004-2010) from the Society of Thoracic Surgeons Congenital Heart Surgery (STS-CHS) Database (clinical registry) and the Pediatric Health Information Systems (PHIS) database (administrative database) from hospitals participating in both to evaluate differential coding/classification of operations between datasets and subsequent impact on outcomes assessment. ⋯ This study demonstrates differences in case ascertainment between administrative and clinical registry data for children undergoing cardiac operations, which translated into important differences in outcomes assessment.
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Multicenter Study
American College of Surgeons National Surgical Quality Improvement Program Pediatric: a beta phase report.
The American College of Surgeons (ACS) National Surgical Quality Improvement Program Pediatric (NSQIP-P) expanded to beta phase testing with the enrollment of 29 institutions. Data collection and analysis were aimed at program refinement and development of risk-adjusted models for inter-institutional comparisons. ⋯ This report represents the first risk-adjusted hospital-level comparison of surgical outcomes in infants and children using NSQIP-P data. Programmatic and analytic modifications will improve the impact of this program as it moves into full implementation. These results indicate that NSQIP-P has the potential to serve as a model for determining risk-adjusted outcomes in the neonatal and pediatric population with the goal of developing quality improvement initiatives for the surgical care of children.
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Critical care medicine · Jan 2013
Multicenter StudyThe association between ICU readmission rate and patient outcomes.
To examine the association between ICU readmission rates and case-mix-adjusted outcomes. ⋯ Patients readmitted to ICUs have increased hospital mortality and lengths of stay. After case-mix adjustment, there were no significant differences in standardized mortality or case-mix-adjusted lengths of stay between units with high readmission rates compared to units with moderate or low rates. The use of readmission as a quality measure should only be implemented if patient case-mix is taken into account.
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Critical care medicine · Dec 2012
Multicenter StudyPediatric Acute Lung Injury Epidemiology and Natural History study: Incidence and outcome of the acute respiratory distress syndrome in children.
The incidence and outcome of the acute respiratory distress syndrome in children are not well-known, especially under current ventilatory practices. The goal of this study was to determine the incidence, etiology, and outcome of acute respiratory distress syndrome in the pediatric population in the setting of lung protective ventilation. ⋯ This is the largest study to estimate prospectively the pediatric population-based acute respiratory distress syndrome incidence and the first incidence study performed during the routine application of lung protective ventilation in children. Our findings support a lower acute respiratory distress syndrome incidence and mortality than those reported for adults. PaO2/FIO2 ratios at acute respiratory distress syndrome onset and at 24 hrs after onset were helpful in defining groups at greater risk of dying (clinical trials registered with http://www.clinicaltrials.gov; NCT 01142544).
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Multicenter Study
Impact of skill mix variations on patient outcomes following implementation of nursing hours per patient day staffing: a retrospective study.
This article is a report of a study of the association between skill mix and 14 nursing-sensitive outcomes following implementation of the nursing hours per patient day staffing method in Western Australian public hospitals in 2002, which determined nursing hours by ward category but not skill mix. ⋯ The skill mix of nurses providing care could impact patient outcomes and is an important consideration in strategies to improve nurse staffing. Levels of hospital nurse staffing and skill mix are important organizational characteristics when predicting patient outcomes.