Articles: outcome-assessment-health-care.
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Multicenter Study
Patients admitted to Australian intensive care units: impact of remoteness and distance travelled on patient outcome.
To use a geographical information system (GIS) to explore the impact of (i) patient remoteness and (ii) distance travelled to an Australian public-hospital intensive care unit on patient outcomes. ⋯ For patients who were admitted to the ICU after being transferred from another hospital, greater remoteness and greater distance travelled were not associated with increased mortality, but LOS in the hospital and the ICU was longer.
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Intensive care medicine · Nov 2012
Multicenter Study Comparative StudyChest radiographs in 104 French ICUs: current prescription strategies and clinical value (the RadioDay study).
To analyze the current practices of chest radiograph (CXR) prescription and their clinical impact. ⋯ Nearly two-thirds of the participating ICUs adopted the "on-demand" strategy of prescription, which was associated with a lower rate of CXRs with no increase in unscheduled CXRs and was of higher clinical value than a "daily routine in MV" strategy. Importantly, the study design did not allow assessing if the "on-demand" strategy had missed or delayed some diagnoses.
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Multicenter Study Comparative Study
Urgent readmission rates can be used to infer differences in avoidable readmission rates between hospitals.
Most of the urgent readmissions are unavoidable. This study developed a method that used observed urgent readmission rates to compare the latent avoidable readmission rates between the two hospitals. ⋯ Urgent readmission rates can be used to estimate the probability that avoidable readmission rates differ significantly between the two hospitals. The probability that avoidable readmission rates differ significantly between hospitals is small even when significant differences in urgent 30-day readmission rates exist. Our results show that 30-day urgent readmission rates should be used very cautiously to compare hospital quality of care.
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Multicenter Study Clinical Trial
Spine patient outcomes research trial: do outcomes vary across centers for surgery for lumbar disc herniation?
Lumbar discectomy is the most commonly performed spine procedure. Academic spine centers with potentially differing caseloads and experience may have different outcomes. ⋯ Although mean blood loss, risk of durotomy, length of stay, and rate of reoperation vary among academic spine centers performing lumbar discectomy, there appears to be no difference in long-term functional outcomes.
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Randomized Controlled Trial Multicenter Study
Who should have surgery for spinal stenosis? Treatment effect predictors in SPORT.
Combined prospective randomized controlled trial and observational cohort study of spinal stenosis (SpS) with an as-treated analysis. ⋯ With the exception of smokers, patients who met strict inclusion criteria improved more with surgery than with nonoperative treatment, regardless of other specific characteristics. However, TE varied significantly across certain subgroups, and these data can be used to individualize shared decision making discussions about likely outcomes. Smoking cessation should be considered before surgery for SpS.