A quality indicator can be biased by intra-hospital heterogeneity: the case for quality of patient record keeping in France.
Background: Since 2008, French health institutions providing medical, surgical and obstetrical care are assessed on the basis of a set of quality indicators. The French National Authority for Health developed a survey design in which 80 records are randomly selected from each institution. The main a...
| Publicado en: | European Journal of Public Health Vol. 25; no. 5; pp. 787 - 792 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
10/1/2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=110128924&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 110128924 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11011262 BHW jtl: European Journal of Public Health issn: 11011262 maglogo: N pubinfo: dt: 10/1/2015 vid: 25 iid: 5 pid: 622 pub: Oxford University Press / USA artinfo: ui: 110128924 110128924 110128924 10.1093/eurpub/ckv085 NLM25983328 110128924 ppf: 787 ppct: 5 formats: fmt: @attributes: type: P tig: atl: A quality indicator can be biased by intra-hospital heterogeneity: the case for quality of patient record keeping in France. aug: au: Lelong, Audrey Leger, Stéphanie Vendittelli, Françoise Blanquet, Marie Cong-Tri Thuong Belgacem, Bénédicte Gerbaud, Laurent affil: Department of Public Health, Clermont-Ferrand University Hospital Center, Clermont-Ferrand, France sug: subj: Clinical Indicators Patient Record Systems France Hospitals Organizational Structure France Random Sample Simulations Databases Academic Medical Centers Descriptive Statistics Confidence Intervals Intraclass Correlation Coefficient kappa Statistic Data Analysis Software Funding Source ab: Background: Since 2008, French health institutions providing medical, surgical and obstetrical care are assessed on the basis of a set of quality indicators. The French National Authority for Health developed a survey design in which 80 records are randomly selected from each institution. The main aim was to assess the effects of internal heterogeneity of a hospital that comprises several units. The survey method is based on the hypothesis of intra-institution homogeneity, which overlooks the fact that in wide hospitals homogeneity is related to departments and thus leads to overall intra-hospital heterogeneity. Methods: Simulated databases were created to modelise the heterogeneity of our hospital and computed to assess the reliance of indicator measurement. We used real data from a large teaching hospital having internal heterogeneity related to each department. Results: Variance under heterogeneity was greater than under homogeneity (3-to 18-fold) leading to an increased size of the confidence interval (CI) (at 95%) from 9 (given Haute Autorité de Santé sources) to 22 (for greatest internal heterogeneity). Conclusions: The variations in a quality indicator can be explained by intra-institution heterogeneity and are not related to changes in the quality policy of the hospitals and may lead to errors in terms of pay for performance. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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