Articles: outcome-assessment-health-care.
-
Comparative Study
Variation in trauma resuscitation and its effect on patient outcome.
There were significant differences in the time taken to resuscitate 257 trauma patients from four internationally recognized trauma centres. The fastest unit completed resuscitation in 15 min while the slowest took 105 min. This variation was not explained by differences in the type of patient dealt with, seniority of the team leader, or the number of personnel in the trauma team. ⋯ Although the slowest unit had the smallest trauma team (two people), larger numbers of personnel did not shorten resuscitation times. The time taken to carry out the ABC of the primary survey was significantly correlated with patient's physiological change in the resuscitation room (R = -0.63, P less than 0.0001 with systolic blood pressure; R = -0.68, P less than 0.01 with the revised trauma score). A multiple regression with survival as the dependent variable revealed that this time was also a predictor of the patient's eventual outcome (t = 3.18, P less than 0.005).
-
Careful review of the literature suggests that the conceptual problem in analyzing hospitals' quality of care is the difficulty of identifying problem domains of hospital care. An appropriate measurement model using multiple indicators of hospital quality problems is developed and evaluated. ⋯ The findings show that hospital characteristics exert limited effects on adverse outcomes. Efficiency and average length of stay are the only statistically significant factors that explain the variation in adverse outcomes.
-
Healthc Manage Forum · Jan 1992
Hospital reimbursement in Alberta: outcomes management is on the way.
The Alberta government has initiated a process to alter fundamentally the way it pays hospitals. As with most provinces, Alberta has been paying hospitals for what they spend. The new Alberta model will initially pay hospitals for what they do and ultimately will pay hospitals for what they ought to do; that is, for the outcomes that should be achieved. ⋯ The HPI is the average predicted cost per case divided by the unweighted average actual cost per case. The HPI is intended as an interim measure only. Ultimately, the system will evolve into a true prospective case-based system with volume controlled via role statements and linked to clinical outcomes.