[Data validity in a French diagnosis-related group information program]. / Validité de la description d'un groupe spécifique de patients par le PMSI-SSR.

BACKGROUND: Long-term intratracheal ventilated patients need continuous artificial ventilation support. After the acute periods, these patients may benefit from dedicated follow-up in rehabilitation care centers. In this paper, we aimed to study the validity of the data provided by a French diagnosis-related group (DRG) information system. METHODS: For a sample of intratracheal ventilated patients in two rehabilitation units, we compared the data provided in the DRG information system with the data available in the medical charts. Furthermore, we asked the medical, nursing and allied health staff to assess the data provided by the French DRG information system. RESULTS: The diagnosis was found accurate for 86% of hospital stays. In the DRG information system, 77% of the medical care, and 39% of the nursing and allied health care were mentioned correctly. Overall, 55% of the nursing and allied health care procedures in the DRG information system were not reported in the medical charts. The healthcare providers estimated that the frequency of the care provided was underestimated in the DRG information system for 30% of the nursing and allied health care. CONCLUSION: The patients' main characteristics were found correctly reported in the DRG information system. However, the diversity and the frequency of the care provided were underestimated. These underestimates were mainly related to care frequently provided in these patients (for example, urinary catheterization, massages, counseling for relatives).

[Evaluation of decontamination interventions in 59 homes of children with lead poisoning]. / Evaluation des travaux de décontamination de 59 logements d'enfants atteints de saturnisme.

Old peeling paint with high content of lead has been identified as the main source of lead poisoning for children screened in Paris since 1985. In 1989, Médecins Sans Frontières and Migration Santé tested abatement methods in 59 homes of severely lead-poisoned children. The effectiveness of abatement is evaluated with respect to the evolution in dust lead contents and of the children's blood lead levels. Lead content wsas measured in dust samples collected from the floor of the homes before abatement, then every three months after abatement; results are available for 24 homes. Blood lead levels were assessed in the course of the children's medical follow-up; results are available before and after abatement for 78 children living in 41 of the abated homes. The effect of abatement on the children's blood lead level was assessed through multivariate analysis. The median decrease in dust lead contents was 365 micrograms/m2 one to two months after abatement and 300 micrograms/m2 three to six months after abatement. However, dust lead contents of more than 1,000 micrograms/m2 were found in more than half of the communal areas of the buildings six to twenty-eight months after abatement. For 2 of the families, abatement was associated with an increase in the children's blood lead-levels. For all of the other children, abatement was associated with a significant decrease in blood lead levels, controlling for the child's age and initial lead poisoning level, and for the overall downward trend in blood lead levels over time since the initial screening.(ABSTRACT TRUNCATED AT 250 WORDS)