[Assessment of care quality in department of general surgery : usefulness of administrative database].
Identifieur interne : 000162 ( Main/Exploration ); précédent : 000161; suivant : 000163[Assessment of care quality in department of general surgery : usefulness of administrative database].
Auteurs : Imen Samaali [Tunisie] ; Samia Ben Osman ; Riadh Bedoui ; Ibtissem Bouasker ; Youssef Chaker ; Ramzi Nouira ; Chadli DziriSource :
- La Tunisie medicale [ 0041-4131 ] ; 2012.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Assurance de la qualité des soins de santé (méthodes), Bases de données factuelles (statistiques et données numériques), Chirurgie générale (normes), Chirurgie générale (organisation et administration), Chirurgie générale (statistiques et données numériques), Complications postopératoires (mortalité), Complications postopératoires (épidémiologie), Dossiers médicaux (statistiques et données numériques), Département hospitalier de chirurgie (normes), Département hospitalier de chirurgie (statistiques et données numériques), Femelle (MeSH), Humains (MeSH), Morbidité (MeSH), Mâle (MeSH), Sujet âgé (MeSH).
- MESH :
- mortalité : Complications postopératoires.
- méthodes : Assurance de la qualité des soins de santé.
- normes : Chirurgie générale, Département hospitalier de chirurgie.
- organisation et administration : Chirurgie générale.
- statistiques et données numériques : Bases de données factuelles, Chirurgie générale, Dossiers médicaux, Département hospitalier de chirurgie.
- épidémiologie : Complications postopératoires.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Morbidité, Mâle, Sujet âgé.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Databases, Factual (statistics & numerical data), Female (MeSH), General Surgery (organization & administration), General Surgery (standards), General Surgery (statistics & numerical data), Humans (MeSH), Male (MeSH), Medical Records (statistics & numerical data), Middle Aged (MeSH), Morbidity (MeSH), Postoperative Complications (epidemiology), Postoperative Complications (mortality), Quality Assurance, Health Care (methods), Surgery Department, Hospital (standards), Surgery Department, Hospital (statistics & numerical data).
- MESH :
- epidemiology : Postoperative Complications.
- methods : Quality Assurance, Health Care.
- mortality : Postoperative Complications.
- organization & administration : General Surgery.
- standards : General Surgery, Surgery Department, Hospital.
- statistics & numerical data : Databases, Factual, General Surgery, Medical Records, Surgery Department, Hospital.
- Adult, Aged, Female, Humans, Male, Middle Aged, Morbidity.
Abstract
BACKGROUND
Administrative database, used previously for control of cost, patient flow and invoicing, offer to researchers a large sample of patients representative of population providing interesting informations in the field of descriptive and analytic epidemiology with less cost.
AIM
To assess the usefulness of administrative database for quality of care and research.
METHODS
It was a prospective study concerning 4690 hospitalisations in Department B of General Surgery of hôpital Charles Nicolle during a period of 18 months, between June 1st, 2008 and December 31st, 2009. A descriptive analysis followed by a pronostic study with a univariate and multivariate analysis was performed. RÉSULTATS : Our study showed the usefulness of an administrative database in assessing the quality of care, it allowed us to determine postoperative mortality rate (2.7%), deep morbidity (2.5%), parietal morbidity (1.2%), medical complications (6%), nosocomial infections (3.6%) and re intervention (2.7%), with independent predictive factors of these events. To reduce the incidence of these events we should reduce length of pre-operative stay, prevent intra operative accidents, avoid intra operative bleeding in order to reduce intra operative transfusions and avoid as far as possible the stay in ICU Independent predictors of post trauma death are multiple trauma [OR: 6.14, 95% (from 1.68 to 16.94), p = 0.002], a traumatized patient in distress on arrival [OR: 8.74, 95% (3.59 -27.77), p = 0.000] and overall medical complications [OR: 13.18, 95% (from 4.01 to 31.25), p=0.000]. The ISS is a good discriminative indice to assess the severity and life-threatening risk.
CONCLUSION
Administrative databases provide information on the efficiency of care, it helps to realise observational studies on large samples representative of the population at low cost. They are very useful in the research, despite the lack of clinical data.
PubMed: 22693082
Affiliations:
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Le document en format XML
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<series><title level="j">La Tunisie medicale</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Databases, Factual (statistics & numerical data)</term>
<term>Female (MeSH)</term>
<term>General Surgery (organization & administration)</term>
<term>General Surgery (standards)</term>
<term>General Surgery (statistics & numerical data)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Medical Records (statistics & numerical data)</term>
<term>Middle Aged (MeSH)</term>
<term>Morbidity (MeSH)</term>
<term>Postoperative Complications (epidemiology)</term>
<term>Postoperative Complications (mortality)</term>
<term>Quality Assurance, Health Care (methods)</term>
<term>Surgery Department, Hospital (standards)</term>
<term>Surgery Department, Hospital (statistics & numerical data)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Assurance de la qualité des soins de santé (méthodes)</term>
<term>Bases de données factuelles (statistiques et données numériques)</term>
<term>Chirurgie générale (normes)</term>
<term>Chirurgie générale (organisation et administration)</term>
<term>Chirurgie générale (statistiques et données numériques)</term>
<term>Complications postopératoires (mortalité)</term>
<term>Complications postopératoires (épidémiologie)</term>
<term>Dossiers médicaux (statistiques et données numériques)</term>
<term>Département hospitalier de chirurgie (normes)</term>
<term>Département hospitalier de chirurgie (statistiques et données numériques)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Morbidité (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Postoperative Complications</term>
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<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Quality Assurance, Health Care</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Postoperative Complications</term>
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<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Complications postopératoires</term>
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<keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Assurance de la qualité des soins de santé</term>
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<keywords scheme="MESH" qualifier="normes" xml:lang="fr"><term>Chirurgie générale</term>
<term>Département hospitalier de chirurgie</term>
</keywords>
<keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Chirurgie générale</term>
</keywords>
<keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>General Surgery</term>
</keywords>
<keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>General Surgery</term>
<term>Surgery Department, Hospital</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Databases, Factual</term>
<term>General Surgery</term>
<term>Medical Records</term>
<term>Surgery Department, Hospital</term>
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<keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Bases de données factuelles</term>
<term>Chirurgie générale</term>
<term>Dossiers médicaux</term>
<term>Département hospitalier de chirurgie</term>
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<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Complications postopératoires</term>
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<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Morbidity</term>
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<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Femelle</term>
<term>Humains</term>
<term>Morbidité</term>
<term>Mâle</term>
<term>Sujet âgé</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Administrative database, used previously for control of cost, patient flow and invoicing, offer to researchers a large sample of patients representative of population providing interesting informations in the field of descriptive and analytic epidemiology with less cost.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>AIM</b>
</p>
<p>To assess the usefulness of administrative database for quality of care and research.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>It was a prospective study concerning 4690 hospitalisations in Department B of General Surgery of hôpital Charles Nicolle during a period of 18 months, between June 1st, 2008 and December 31st, 2009. A descriptive analysis followed by a pronostic study with a univariate and multivariate analysis was performed. RÉSULTATS : Our study showed the usefulness of an administrative database in assessing the quality of care, it allowed us to determine postoperative mortality rate (2.7%), deep morbidity (2.5%), parietal morbidity (1.2%), medical complications (6%), nosocomial infections (3.6%) and re intervention (2.7%), with independent predictive factors of these events. To reduce the incidence of these events we should reduce length of pre-operative stay, prevent intra operative accidents, avoid intra operative bleeding in order to reduce intra operative transfusions and avoid as far as possible the stay in ICU Independent predictors of post trauma death are multiple trauma [OR: 6.14, 95% (from 1.68 to 16.94), p = 0.002], a traumatized patient in distress on arrival [OR: 8.74, 95% (3.59 -27.77), p = 0.000] and overall medical complications [OR: 13.18, 95% (from 4.01 to 31.25), p=0.000]. The ISS is a good discriminative indice to assess the severity and life-threatening risk.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>Administrative databases provide information on the efficiency of care, it helps to realise observational studies on large samples representative of the population at low cost. They are very useful in the research, despite the lack of clinical data.</p>
</div>
</front>
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