Appraising hospital performance by using the JCHAO/CMS quality measures in Southern Italy

Autor: Pierluigi Coscarelli, Paolo Rizza, Carmelo G A Nobile, Maria Pavia, Claudia Pileggi, Domenico Flotta
Přispěvatelé: Flotta, D, Rizza, P, Coscarelli, P, Pileggi, C, Nobile, Cg, Pavia, M
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Male
Non-Clinical Medicine
Pulmonology
Health Care Providers
Myocardial Infarction
lcsh:Medicine
Cardiovascular
Medical Records
Health care
Quality of Care
Myocardial infarction
Health Systems Strengthening
lcsh:Science
Multidisciplinary
Evidence-Based Medicine
Mortality rate
Medical record
Hospitals
Lower Respiratory Tract Infections
Surgical Care Improvement Project
Italy
Evidence-Based Practice
Medicine
Female
Health Services Research
Research Article
medicine.medical_specialty
Evidence-based practice
Academic Medicine
Medication Adherence
Physicians
medicine
Humans
Health Care Quality
Intensive care medicine
Aged
Quality Indicators
Health Care
Retrospective Studies
Heart Failure
Treatment Guidelines
Health Care Policy
business.industry
Acute Cardiovascular Problems
lcsh:R
Retrospective cohort study
Pneumonia
medicine.disease
General Surgery
Respiratory Infections
Surgery
lcsh:Q
Health Statistics
business
Medicaid
Surgery Department
Hospital
Zdroj: PLoS ONE, Vol 7, Iss 11, p e48923 (2012)
PLoS ONE
ISSN: 1932-6203
Popis: Objectives The main objective of the present study was to estimate the uptake to quality indicators that reflect the current evidence-based recommendations and guidelines. Methods A retrospective review of medical records of patients admitted to two hospitals in the South of Italy was conducted. For the purposes of the analysis, a sets of quality indicators has been used from the Joint Commission on Accreditation of Hospital Organizations and Centers for Medicare & Medicaid Services. Four areas of care were selected: acute myocardial infarction (AMI), heart failure (HF), pneumonia (PN), and surgical care improvement project (SCIP). Frequency or median was calculated, as appropriate, for each indicator. A composite score was calculated to estimate the overall performance for each area of care. Results A total of 1772 medical records were reviewed. The adherence rates showed a wide-ranging variability among the selected indicators. The use of aspirin and angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) for AMI, the use of ACEI or ARB for HF, the use of appropriate thromboembolism prophylaxis and appropriate hair removal for surgical patients almost approached optimal adherence. At the other extreme, rates regarding adherence to smoking-cessation counseling in AMI and HF patients, discharge instructions in HF patients, and influenza and pneumococcal vaccination in pneumonia patients were noticeably intangible. Overall, the recommended processes of care among eligible patients were provided in 70% for AMI, in 32.4% for HF, in 46.4% for PN, and in 46% for SCIP. Conclusions The results show that there is still substantial work that lies ahead on the way to improve the uptake to evidence-based processes of care. Improvement initiatives should be focused more on domains of healthcare than on specific conditions, especially on the area of preventive care.
Databáze: OpenAIRE
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