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Quality Indicators And Healthcare. A First Step To The Evaluation Of A Hospital’s Performance. Introdução à Medicina 2008/2009. Authors. Ana Cristina Pereira Ana Teresa Carapenha Ana Rita Oliveira André Vinha Catarina Vieira Eduardo Freitas João Rebelo Mariana Oliveira
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Quality Indicators AndHealthcare A FirstStep To TheEvaluationOf A Hospital’s Performance Introdução à Medicina 2008/2009 Authors Ana Cristina Pereira Ana Teresa Carapenha Ana Rita Oliveira André Vinha Catarina Vieira Eduardo Freitas João Rebelo Mariana Oliveira Marli Cruz Nuno Ribeiro Victoriano Costa
QualityOfHealthcare Indicators Performance measuring The indicators are the source of information to evaluate the performance of a hospital. KIRKMAN, Jamie John, Bouamra, Omar , 2008. Introdução à Medicina - Turma 10
QualityOfHealthcare Valuesofindicators Withoutdifferentsourcesof data Unreliableconclusions Introdução à Medicina - Turma 10
QualityOfHealthcare Indicators Usefulinformation Posterior performance measurements Values of the indicators as the basis to evaluate healthcare quality. Eddy, David M., 1998 Introdução à Medicina - Turma 10
ResearchQuestionandMainAim How did quality and performance indicators evolve through the years in a central hospital? Our main objective is to calculate these indicators concerning different variables and to have a perspective of the performance of the hospital in case. Definitive conclusions demand a more exaustive study. Introdução à Medicina - Turma 10
SpecificAims • Examination of healthcare quality. • Definition of a hospital’s activity and production. • Study of the quality of the data. How will we do this? Introdução à Medicina - Turma 10
Methods Episodesin a central hospital, between 1990 and 2007 Outpatientepisodes Mortality Carequality Qualityof data Hospital’sactivity Postponedsurgeries Outpatientsurgery Principal diagnosis Surgicalcomplications Childbirthofcaesarianoperation Timeofinternment Timeofinternment Introdução à Medicina - Turma 10
Methods SPSS (Statistical Package for the Social Sciences) Provider of predictive analytics software and solutions. (*) SPSS Indicators’ calculation Global values Others According to DRGs According to gender According to age group (*) SPSS: The Predictive Analytics Company: http://www.spss.com/corpinfo/?source=homepage&hpzone=nav_bar Introdução à Medicina - Turma 10
Methods DRGs “A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay.” (*) ICD-9-CM “ICD-9-CM is the official system of assigning codes to diagnoses and procedures associated with hospital utilization in the United States.” (**) INE “The entity responsible for ensuring the production and dissemination of official statistical information.” (***) (*) MeSh definition (**) Classifications of Diseases and Functioning & Disability: http://www.cdc.gov/nchs/about/otheract/icd9/abticd9.htm (***) Statistics Portugal: http://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_cont_inst&ine_smenu.boui=13918434&INST=53864&xlang=en Introdução à Medicina - Turma 10
Methods Ganttchart Flowchart Graphicsandtables Introdução à Medicina - Turma 10
ExpectedResults Introdução à Medicina - Turma 10
ExpectedResults Introdução à Medicina - Turma 10
ExpectedResults Introdução à Medicina - Turma 10
References • EDDY, David M. ‘’Performance measurements: problems and solutions in Health Affairs. Vol.17. 4, 1998. • Reinhardt,U: ‘’Quality in comsumer Driven Health Systems’’, International Journal for Health Care. 1998; 10(5) • Bentes, Margarida; Berardo, Ana; Matias, Alberto: XVII Congresso da União Europeia de Gestores Hospitalares; 1999. • Gardner, Karen L; Sibthorpe, Beverly; Longstaff, Duncan. National quality and performance system for Divisions of General Practice: early reflections on a system under development. 2007 • Geraedts M, Schwartze D, Molzahn T. Hospital qualityreportsinGermany: patientandphysicianopinion of the reported quality indicators. Germany: BMC Health Serv Res.; 2007 Sep 28; 7-157. • Bentes, Margarida; Gonçalves, Maria da Luz; Tranquada, Suzete; Urbano, João. A utilização dos GDH’s como instrumento de financiamento hospitalar. Gestão Hospital, 33-42. • Briz, Teodoro; Dias, Carlos Matias; Freitas, Mário. Indicadores de saúde: uma visão de Saúde Pública, com interesse em Medicina Geral e Familiar. Revista Portuguesa Clínica Geral 2007;23:439-50 • Ribeiro, Nuno. Administração pública. TOC. 2000/08 • Uriel, Zanon. Qualidade da assistência médico-hospitalar: conceito e avaliação de indicadores. 2000 Jul-Set RAS _ Vol. 2, Nº 8. Available from: http://www.cqh.org.br/files/ARTIGORAS08.pdf Introdução à Medicina - Turma 10
References • National report on health sector performance indicators 2003 [Internet]. Canberra: . Australian Institute of Health and Welfare; 2004. • Dimick, Justin B., Welch, H. Gilbert, Birkmeyer, John D. Surgical Mortality as an Indicator of Hospital Quality: The Problem With Small Sample Size. JAMA. 2004;292:847-851. • ClassificationsofDiseasesandFunctioning & Disability: InternationalClassificationofDiseases, NinthRevision, ClinicalModification (ICD-9-CM). [Cited 2 Dec 2008] Availablefrom: http://www.cdc.gov/nchs/about/otheract/icd9/abticd9.htm • SPSS: ThePredictiveAnalyticsCompany. [Cited 16 Dec 2008] Availablefrom: http://www.spss.com/corpinfo/?source=homepage&hpzone=nav_bar • Statistics Portugal. [Cited 17 Dec 2008] Availablefrom: http://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_cont_inst&ine_smenu.boui=13918434&INST=53864&xlang=en