Articles: outcome-assessment-health-care.
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Multicenter Study Comparative Study
The effect of trauma center designation and trauma volume on outcome in specific severe injuries.
The objective of this study was to investigate the effect of American College of Surgeons (ACS) trauma center designation and trauma volume on outcome in patients with specific severe injuries. ⋯ Level I trauma centers have better outcomes than lower-level centers in patients with specific injuries associated with high mortality and poor functional outcomes. The volume of major trauma admissions does not influence outcome in either level I or II centers. These findings may have significant implications in the planning of trauma systems and the billing of services according to level of accreditation.
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Multicenter Study Comparative Study
Scottish urban versus rural trauma outcome study.
Outcome following trauma and health care access are important components of health care planning. Resources are limited and quality information is required. We set the objective of comparing the outcomes for patients suffering significant trauma in urban and rural environments in Scotland. ⋯ Long prehospital times in the rural environment were not associated with differences in mortality or length of stay in moderately and severely injured patients in the west of Scotland. This may lend support to a policy of rationalization of trauma services in Scotland.
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Multicenter Study Comparative Study
Adherence to heart failure quality-of-care indicators in US hospitals: analysis of the ADHERE Registry.
Quality-of-care indicators have been developed for patients hospitalized with heart failure. However, little is known about current rates of conformity with these indicators or their variability across hospitals. ⋯ Among hospitals providing care for patients with heart failure, there is significant individual variability in conformity to quality-of-care indicators and clinical outcomes and a substantial gap in overall performance. Establishing educational initiatives and quality improvement systems to reduce this variability and eliminate this gap would be expected to substantially improve the care of these patients.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Impact of care at a multidisciplinary congestive heart failure clinic: a randomized trial.
Although multidisciplinary congestive heart failure clinics in the United States appear to be effective in reducing the number of hospital readmissions, it is unclear whether the same benefit is seen in countries such as Canada, where access to both general and specialized medical care is free and unrestricted. We sought to determine the impact of care at a multidisciplinary specialized outpatient congestive heart failure clinic compared with standard care. ⋯ Compared with usual care, care at a multidisciplinary specialized congestive heart failure outpatient clinic reduced the number of hospital readmissions and hospital days and improved quality of life. When our results are integrated with those from other, similar trials, multidisciplinary disease management strategies for congestive heart failure are associated with clinically worthwhile improvements in survival.
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Multicenter Study Comparative Study
Health outcomes in decompensated congestive heart failure: a comparison of tertiary hospitals in Brazil and United States.
Few international studies prospectively compared evidence-based practices and health outcomes among congestive heart failure (CHF) cohorts from countries with different cultural and economic backgrounds. ⋯ Medical practice and health-related outcomes were different between U.S. and Brazilian congestive heart failure patients. In order to improve management worldwide, potential factors (structural, cultural or disease-related) that might be associated with these differences need to be evaluated in future studies.