Hospital-acquired complications: the relative importance of hospital- and patient-related factors.

Autor: Duke GJ; Box Hill Hospital, Melbourne, VIC.; Eastern Health Clinical School, Monash University, Melbourne, VIC., Moran JL; Queen Elizabeth Hospital, Adelaide, SA., Bersten AD; Flinders Medical Centre, Adelaide, SA., Bihari S; Flinders Medical Centre, Adelaide, SA., Roodenburg O; Eastern Health Clinical School, Monash University, Melbourne, VIC.; Eastern Health, Melbourne, VIC., Karnon J; Flinders University, Adelaide, SA., Hirth S; Eastern Health, Melbourne, VIC., Hakendorf P; Flinders Medical Centre, Adelaide, SA., Santamaria JD; St Vincent's Hospital Melbourne, Melbourne, VIC.
Jazyk: angličtina
Zdroj: The Medical journal of Australia [Med J Aust] 2022 Mar 21; Vol. 216 (5), pp. 242-247. Date of Electronic Publication: 2021 Dec 30.
DOI: 10.5694/mja2.51375
Abstrakt: Objective: To quantify the prevalence of hospital-acquired complications; to determine the relative influence of patient- and hospital-related factors on complication rates.
Design, Participants: Retrospective analysis of administrative data (Integrated South Australian Activity Collection; Victorian Admitted Episodes Dataset) for multiple-day acute care episodes for adults in public hospitals.
Setting: Thirty-eight major public hospitals in South Australia and Victoria, 2015-2018.
Main Outcome Measures: Hospital-acquired complication rates, overall and by complication class, by hospital and hospital type (tertiary referral, major metropolitan service, major regional service); variance in rates (intra-class correlation coefficient, ICC) at the patient, hospital, and hospital type levels as surrogate measures of their influence on rates.
Results: Of 1 558 978 public hospital episodes (10 029 918 bed-days), 151 486 included a total of 214 286 hospital-acquired complications (9.72 [95% CI, 9.67-9.77] events per 100 episodes; 2.14 [95% CI, 2.13-2.15] events per 100 bed-days). Complication rates were highest in tertiary referral hospitals (12.7 [95% CI, 12.6-12.8] events per 100 episodes) and for episodes including intensive care components (37.1 [95% CI, 36.7-37.4] events per 100 episodes). For all complication classes, inter-hospital variation was determined more by patient factors (overall ICC, 0.55; 95% CI, 0.53-0.57) than by hospital factors (ICC, 0.04; 95% CI, 0.02-0.07) or hospital type (ICC, 0.01; 95% CI, 0.001-0.03).
Conclusions: Hospital-acquired complications were recorded for 9.7% of hospital episodes, but patient-related factors played a greater role in determining their prevalence than the treating hospital.
(© 2021 AMPCo Pty Ltd.)
Databáze: MEDLINE
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