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Article
Publication date: 3 May 2011

Cristina Rodríguez‐Rieiro, Paz Rodríguez Pérez, Susana Granado de la Orden, Mercedes Moreno Moreno, Ana Chacón García and Amaya Sánchez‐Gómez

The paper's purpose is twofold: to provide a predictive model for estimating in‐hospital mortality rates after coronary artery bypass grafting (CABG) in Spanish autonomous regions…

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Abstract

Purpose

The paper's purpose is twofold: to provide a predictive model for estimating in‐hospital mortality rates after coronary artery bypass grafting (CABG) in Spanish autonomous regions (AR) after adjusting relevant factors; and to determine whether there is a difference between expected and observed mortality rates.

Design/methodology/approach

All patients registered in a minimum basic data set (MSBD) undergoing CABG between 2000 and 2004 were selected. After bivariate analysis to explore associations between in‐hospital death and other variables, a multivariate analysis using logistic regression was conducted. The predictive model was evaluated using calibration and discrimination techniques. Standardized mortality ratios by AR were calculated.

Findings

The expected Spanish in‐hospital mortality rate after CABG was 7.68 and the observed rate was 7.69 deaths per 100 operations. Discrimination obtained with the model resulted in an area under the curve of 0.70 (95 per cent CI, 0.69‐0.71). When each AR's mortality rate is calculated and compared with the observed rate, some ARs present an observed mortality rate higher or lower than the expected rate according to adjusted variables in the model.

Research limitations/implications

The MSBD registry does not contain patients' critical data, such as arterial damage severity, or in which hospital procedures were performed.

Practical implications

There are factors related to individual patient variation, financial resources or healthcare quality in different ARs, which should be investigated in follow‐up studies.

Originality/value

The paper shows that, although the global expected mortality rate is almost the same as the observed Spanish mortality rate, this similarity disappears when AR rates are compared.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

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Article
Publication date: 18 July 2008

Susana Granado de la Orden, Cristina Rodríguez‐Rieiro, Amaya Sánchez‐Gómez, Ana Chacón García, Tomás Hernández‐Fernández, Ángel Abad Revilla, Dolores Vigil Escribano and Paz Rodríguez Pérez

This paper aims to explore lot quality assurance sampling (LQAS) applicability and usefulness in the evaluation of quality indicators in a hospital emergency department (ED) and…

308

Abstract

Purpose

This paper aims to explore lot quality assurance sampling (LQAS) applicability and usefulness in the evaluation of quality indicators in a hospital emergency department (ED) and to determine the degree of compliance with quality standards according to this sampling method.

Design/methodology/approach

Descriptive observational research in the Hospital General Universitario Gregorio Marañón (HGUGM) emergency department (ED). Patients older than 15 years, diagnosed with dyspnoea, chest pain, urinary tract colic or bronchial asthma attending the HGUGM ED from December 2005 to May 2006, and patients admitted during 2005 with exacerbation of chronic obstructive pulmonary disease or acute meningitis were included in the study. Sample sizes were calculated using LQAS. Different quality indicators, one for each process, were selected. The upper (acceptable quality level (AQL)) and lower thresholds (rejectable quality level (RQL)) were established considering risk α=5 per cent and β=20 per cent, and the minimum number of observations required was calculated.

Findings

It was impossible to reach the necessary sample size for bronchial asthma and urinary tract colic patients. For chest pain, acute exacerbation of chronic obstructive pulmonary disease, and acute meningitis, quality problems were detected. The lot was accepted only for the dyspnoea indicator.

Originality/value

The usefulness of LQAS to detect quality problems in the management of health processes in one hospital's ED. The LQAS could complement traditional sampling methods.

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Available. Content available
588

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 4
Type: Research Article
ISSN: 0952-6862

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