Articles: outcome-assessment-health-care.
-
The 12-lead electrocardiogram (ECG) can capture valuable information in the prehospital setting. By the time patients are assessed by an emergency department (ED) physician, their symptoms and any ECG changes may have resolved. We sought to determine whether the prehospital electrocardiogram (pECG) could influence ED management and how often the pECG was available to and reviewed by the ED physician. ⋯ The pECG has the potential to influence ED management. Improvement in paramedic and physician documentation and a formal pECG handover process appear necessary.
-
The American surgeon · Oct 2011
Multicenter Study Comparative StudyAre all level I trauma centers created equal? A comparison of American College of Surgeons and state-verified centers.
Scant literature investigates potential outcome differences between Level I trauma centers. We compared overall survival and survival after acute respiratory distress syndrome (ARDS) in patients admitted to American College of Surgeons (ACS)-verified versus state-verified Level I trauma centers. Using the National Trauma Data Bank Version 7.0, incident codes associated with admission to an ACS-verified facility were extracted and compared with the group admitted to state-verified centers. ⋯ Level I verification does not necessarily imply similar outcomes in all subgroups. Federal oversight may become necessary to ensure uniformity of care, maximizing outcomes across all United States trauma systems. Further study is needed.
-
Multicenter Study Comparative Study
Estimates of success in patients with sciatica due to lumbar disc herniation depend upon outcome measure.
The objectives were to estimate the cut-off points for success on different sciatica outcome measures and to determine the success rate after an episode of sciatica by using these cut-offs. A 12-month multicenter observational study was conducted on 466 patients with sciatica and lumbar disc herniation. ⋯ In conclusion, the success rates at 12 months varied from 49 to 58% depending on the measure used. The proposed cut-offs may facilitate the comparison of success rates across studies.
-
Multicenter Study
Influence of socioeconomic status on trauma center performance evaluations in a Canadian trauma system.
Trauma center performance evaluations generally include adjustment for injury severity, age, and comorbidity. However, disparities across trauma centers may be due to other differences in source populations that are not accounted for, such as socioeconomic status (SES). We aimed to evaluate whether SES influences trauma center performance evaluations in an inclusive trauma system with universal access to health care. ⋯ We observed an important variation in SES across trauma centers but no change in risk-adjusted mortality estimates when SES was added to adjustment models. Results suggest that after adjustment for injury severity, age, comorbidity, and transfer status, disparities in SES across trauma center source populations do not influence trauma center performance evaluations in a system offering universal health coverage.
-
Purulent skin and soft tissue infections (SSTIs) requiring medical attention are often managed in primary care. The prevalence of SSTIs caused by community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) has been increasing rapidly, including in otherwise healthy individuals. The Centers for Disease Control and Prevention (CDC) issued guidelines to improve the management of SSTIs in primary care. ⋯ In SSTIs, this intervention resulted in increased use of antibiotics, including antibiotics that typically cover MRSA strains, but did not demonstrate increased rates of recommended drainage procedures. It is replicable and portable, and may improve antibiotic selection in other settings.