Précautions et limitations lors de l'utilisation de la mortalité intra-hospitalière comme indicateur de la qualité des soins
Details
Serval ID
serval:BIB_41D2B1E3E220
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Précautions et limitations lors de l'utilisation de la mortalité intra-hospitalière comme indicateur de la qualité des soins
Journal
Revue médicale de la Suisse romande
ISSN
0035-3655
Publication state
Published
Issued date
2004
Volume
124
Number
11
Pages
697-700
Notes
Réf. IUMSP: R 04/101
Notes sur le titre : Titre traduit: Precautions and limitations when using intrahospital mortality as indicator of quality of care
SAPHIRID:45547
Notes sur le titre : Titre traduit: Precautions and limitations when using intrahospital mortality as indicator of quality of care
SAPHIRID:45547
Abstract
INTRODUCTION : La mortalité intra-hospitalière, utilisée comme indicateur de qualité aux USA et en Angleterre pour comparer les performances des hôpitaux est désormais également mesurable en Suisse, mais il parait important de relever les limitations et précautions liées à son utilisation. METHODES: Les données saisies en 2001 pour l'OFS par les hôpitaux valaisans servirent à établir les taux de mortalité globaux et par pathologie et à calculer les risques relatifs de mortalité propres à chaque hôpital, bruts et ajustés. RESULTATS: Les taux bruts de mortalité intra-hospitalière globale variaient de 1.25% à 1.80% selon les hôpitaux. Les taux par pathologie variaient peu, les différences ne reflétant que rarement des risques relatifs statistiquement significatifs après ajustement. DISCUSSION: Le taux de mortalité intra-hospitalière ne saurait être utilisé comme indicateur de qualité sans certaines précautions concernant notamment l'ajustement du "case-mix", l'exclusion de patients en soins palliatifs et l'examen des taux spécifiques par pathologie. [Auteurs]
[Summary] INTRODUCTION: Inhospital mortality has been used as an outcome quality indicator in the USA and in England to compare and benchmark hospital performance. If is now also possible to measure this outcome indicator in Switzerland, but it is important to highlight limitations and precautions to its use. METHODS: We collected administrative data from acute care community hospitals in the Canton of Valais, Switzerland, for the year 2001. We assessed rates of global and disease specific inhospital mortality and calculated crude and adjusted relative risks of inhospital mortality, specific to each hospital. RESULTS: The crude rates of the global inhospital mortality varied from 1.25% to 1.80% between hospitals. The variation for disease specific mortality rates was low. After adjustment, differences between relative risks were almost never statistically significant. DISCUSSION: The use of inhospital mortality as an quality indicator, need to be done with cautions, in particular adjustment for the case-mix, exclusion of patients in palliative care and analysis of disease specific rates. [Authors]
[Summary] INTRODUCTION: Inhospital mortality has been used as an outcome quality indicator in the USA and in England to compare and benchmark hospital performance. If is now also possible to measure this outcome indicator in Switzerland, but it is important to highlight limitations and precautions to its use. METHODS: We collected administrative data from acute care community hospitals in the Canton of Valais, Switzerland, for the year 2001. We assessed rates of global and disease specific inhospital mortality and calculated crude and adjusted relative risks of inhospital mortality, specific to each hospital. RESULTS: The crude rates of the global inhospital mortality varied from 1.25% to 1.80% between hospitals. The variation for disease specific mortality rates was low. After adjustment, differences between relative risks were almost never statistically significant. DISCUSSION: The use of inhospital mortality as an quality indicator, need to be done with cautions, in particular adjustment for the case-mix, exclusion of patients in palliative care and analysis of disease specific rates. [Authors]
Keywords
Hospital Mortality , Hospitals, Community , Quality Indicators, Health Care
Pubmed
Create date
05/03/2008 15:57
Last modification date
20/08/2019 13:42