Abstract:
:The aim of this study was to evaluate the impact of a program of training, education and awareness on the accuracy of the data collected from hospital discharge abstracts. Four random samples of hospital discharge abstracts relating to four different periods were studied. The evaluation of the impact of systematic training and education activities was performed by checking the quality of abstracting information from the medical records. The analysis was carried out at the Istituto Dermopatico dell'Immacolata, a research hospital (335 beds) in Rome, Italy, which specializes in dermatology, plastic and vascular surgery. Error rates in discharge abstracts were subdivided into six categories: selection of the wrong principal diagnosis (type A); low specificity of the principal diagnosis (type B); incomplete reporting of secondary diagnoses (type C); selection of the wrong principal procedure (type D); low specificity of the principal procedure (type E); incomplete reporting of procedures (type F). A specific rate for errors modifying classification in diagnosis related groups (DRG) was then estimated and the effect of re-abstracting on the case-mix index evaluated. Error types A, B, C, E and F dropped from 8.5% to 2%, 15.8 to 4.9, 31.8 to 13.1,4.1 to 0.3 and 22 to 2.6%, respectively. Error type D was 0.7 both in the first (the baseline) and fourth periods of analysis. All differences in error types were statistically significant. In 1999 8.3% of cases were assigned to a different DRG after re-abstracting as compared with 24.3% in the third quarter of 1994, 23.8% in the first quarter of 1995 and 5.5% in September-October 1997. Continuous training and feedback of information to departments have shown to be successful in improving the quality of abstracting information at patient level from the medical record. These positive results were facilitated by the introduction of a prospective payment system to finance inpatient hospital activity. The effort to increase administrative data quality at hospital level facilitates the use of those data sets for internal quality management activities.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Lorenzoni L,Da Cas R,Aparo ULdoi
10.1046/j.1365-2753.2000.00265.xsubject
Has Abstractpub_date
2000-11-01 00:00:00pages
371-7issue
4eissn
1356-1294issn
1365-2753journal_volume
6pub_type
杂志文章abstract:BACKGROUND:Few randomized clinical trials focus on patients' symptoms of the first post-operative week following outpatient (OPS) versus inpatient (IPS) laparoscopic cholecystectomy (LC). The objective was to compare these treatment modalities with regard to patients' perceptions of pain and other post-operative sympto...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2007.00920.x
更新日期:2008-08-01 00:00:00
abstract::In many developed nations, the state of publicly administered health care is increasingly precarious as a result of escalating numbers of chronically ill patients, inadequate medical personnel and hospital facilities, as well as sparse funding for ongoing upgrades to state-of-the-art diagnostic and therapeutic technol...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.2007.00808.x
更新日期:2008-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Smoking during pregnancy can cause several maternal and neonatal health risks, yet a considerable number of pregnant women continue to smoke. The objectives of this study were to test the factorial structure, validity and reliability of the Dutch version of the Modified Reasons for Smokin...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12500
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:To assess the evidence for tai chi in reducing resting blood pressure (BP) in the elderly. METHODS:Databases were searched up to February 2009. All randomized clinical trials (RCTs) testing the effects of tai chi on resting BP in the elderly were considered. The selection of studies, data extraction and val...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.2009.01210.x
更新日期:2010-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The implementation of automated dispensing cabinets (ADCs) in healthcare facilities appears to be increasing, in particular within Australian hospital emergency departments (EDs). While the investment in ADCs is on the increase, no studies have specifically investigated the impacts of ADC...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12445
更新日期:2016-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Adverse events (AEs) among hospitalized patients occur frequently and result in significant sequelae. Federal policy is incentivizing health information technology (HIT) use, although research demonstrating safety benefits from HIT is mixed. Our objective was to evaluate the potential eff...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12139
更新日期:2014-08-01 00:00:00
abstract::The use of process measures in the assessment of the quality of care has been neglected of late. The outcomes movement has gathered momentum and process measurement appears to have been left trailing in the wake. Yet process measures can be sensitive indicators of the quality of care and have many advantages over outc...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.1998.t01-1-00003.x
更新日期:1998-02-01 00:00:00
abstract:INTRODUCTION:How shared decision making (SDM) works with indigenous patient values and preferences is not well understood. Colonization has affected indigenous peoples' levels of trust with institutions, and their world view tends to be distinct from that of nonindigenous people. Building on a programme theory for SDM,...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13307
更新日期:2020-04-01 00:00:00
abstract::Identified as a mental disorder by Emil Kraepelin and Eugen Bleuler (1858-1939), schizophrenia has been subject to various criticisms, on both political and scientific grounds. Still, until the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, as the'Spectrum of Schizophrenia and Othe...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12608
更新日期:2017-10-01 00:00:00
abstract::Cartwright and Munro argued that extrapolation of findings from randomized controlled trials to other settings can be difficult because information about the underlying causal structure and subgroups is often not available. They advocated the use of 'capacities' - that is fixed causal contributions - in predicting eff...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01909.x
更新日期:2012-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The primary aim of this study is to gain an insight into hospital pharmacists' current practice and perceptions towards medicine reconciliation and to identify common challenges preventing pharmacists from providing this service. METHODS:A cross-sectional study was conducted over 2 month...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12565
更新日期:2016-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Invasive pneumococcal diseases (IPD) are associated with substantial burden in adults (≥50 years). Moreover, adults with vascular, metabolic or respiratory diseases have been shown to have a 3-6 times higher risk of IPD when compared with their healthy controls. These persons at higher ri...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12131
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Child psychoanalytic psychotherapy has been criticized for its reluctance to embrace evidence-based practice. This study aims to explore the historical narrative of a sample of child psychoanalytic psychotherapists about progress in developing the evidence base. METHODS:Fourteen psychotherapists were interv...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01638.x
更新日期:2013-08-01 00:00:00
abstract:RATIONALE, AIM AND OBJECTIVES:This paper describes the results of the process evaluation of a physical activity programme for people with intellectual disabilities (ID), including information about the concepts 'fidelity', 'dose delivered', 'satisfaction' and 'context'. METHODS:Qualitative and quantitative methods amo...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12145
更新日期:2014-08-01 00:00:00
abstract::The American College of Radiology develops evidence-based practice guidelines to aid appropriate utilization of radiological procedures. Panel members use expert opinion to weight trade-offs and consensus methods to rate appropriateness of imaging tests. These ratings include an equivocal range, assigned when there is...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12635
更新日期:2017-02-01 00:00:00
abstract:RATIONALE:Self-assessed health (SAH) status is a very simple four-, or five-category self-reported measure of health status that has been shown to be a powerful predictor of mortality, service use and total cost of medical care treatment. It is therefore reasonable to suggest that pre-intervention SAH may influence the...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2005.00563.x
更新日期:2005-10-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical studies show equivalent health outcomes from interventional procedures and treatment with medication only for stable angina patients. However, patients may be subject to overuse or access barriers for interventional procedures and may exhibit suboptimal adherence to medications....
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13341
更新日期:2020-12-01 00:00:00
abstract:RATIONALE:Variability in indications for total hip replacement (THR) and unequal waiting times may limit health care access. OBJECTIVE:To analyse the relationship between appropriateness and previously developed surgical priority instruments. METHOD:Multicentre cross-validation study of patients placed on the waiting...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2753.2010.01362.x
更新日期:2011-02-01 00:00:00
abstract::Progressive improvements in antihypertensive drug therapy over the past four decades have provided clear benefits in limiting cardiovascular complications. Unfortunately, and largely inexplicably, the inclusion in meta-analyses of defective trials plus the employment of inappropriate diagnostic criteria for adverse co...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.2001.00300.x
更新日期:2001-05-01 00:00:00
abstract::The types of diseases, or categories of suffering, referred to as medically unexplained symptoms or syndromes (MUS) are the focus for the following commentary. Such cases seem to invite reflection. The very nature of such complex patterns of disease and suffering raises a number of fundamental epistemological and onto...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12430
更新日期:2016-08-01 00:00:00
abstract::It is common for primary care providers (PCPs) to manage complex multimorbidity. When caring for patients with multimorbidity, PCPs face challenges to tackle several issues within a short consultation in order to address patients' complex needs. Furthermore, some PCPs may lack access to a multidisciplinary team and ne...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13163
更新日期:2019-12-01 00:00:00
abstract::This article draws attention to an absurd feature of contemporary political life that significantly affects health service policy and calls for an urgent explanation. Policies are formed by a process that privileges rhetoric over reality, producing policies that are conceptualized at a later date. Two influential arti...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2002.00361.x
更新日期:2002-05-01 00:00:00
abstract::In this paper we reflect upon and problematize the ways in which 'patient involvement' is interpreted in a substantial proportion of the research literature on involvement and shared decision making. Drawing upon an analysis of this literature we raise concerns about the 'medicalization of involvement' embedded in, an...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01725.x
更新日期:2011-10-01 00:00:00
abstract:RATIONALE:This paper reports an initiative which promoted evidence-based practice in pressure risk assessment and management among home nursing clients in Melbourne, Australia. AIM AND OBJECTIVES:The aim of this study was to evaluate the introduction and uptake of the Australian Wound Management Association Guidelines...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01870.x
更新日期:2013-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Following increased interest in having inter-professional (IP) health care teams engage patients in decision making, we developed a conceptual model for an IP approach to shared decision making (SDM) in primary care. We assessed the validity of the model with stakeholders in Canada. METH...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01515.x
更新日期:2011-08-01 00:00:00
abstract::In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid pr...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13515
更新日期:2020-11-13 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical practice guidelines (CPGs) are significant tools for evidence-based health care quality improvement. The CPG program at King Saud University was launched as a quality improvement program to fulfil the international accreditation standards. This program was a collaboration betwee...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12927
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:Outcome of the first-trimester Down syndrome screening in younger population was less reported before. We present the outcome of this screening in Taiwanese women younger than 35 years old. We also test whether or not the first-trimester Down syndrome screening of women <35 years of age and women >35 years o...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.01095.x
更新日期:2009-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Annual national prevalence surveys have been conducted in the Netherlands over the past 10 years and have revealed high prevalence rates in Dutch nursing homes. Pressure ulcer guideline implementation is one of the factors that can influence prevalence rates. Previous research has shown t...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01487.x
更新日期:2011-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Malnutrition screening is essential to detect and to treat patients with stunting or wasting. The aim was to evaluate the subjective perception of frequency and assessment of malnutrition by health care professionals. RESEARCH METHODS AND PROCEDURES:In a paediatric university hospital, a...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12412
更新日期:2015-10-01 00:00:00