RESUMO
INTRODUCTION: Several institutions are currently evaluating whether it is possible to gather valid, risk-adjusted quality indicators from routine billing data according to section 21 of the German Hospital Reimbursement Law (Krankenhaus-Entgeltgesetz, KHEntG). It is hoped that this method will enable hospitals to obtain quality assurance data in an easy and timely fashion. MATERIALS AND METHODS: For analysis, section 21 data according to KHEntG, quality assurance forms, and patients' medical records of the University Medical Center Ulm were evaluated in comparison to state and federal benchmark data from 2006. RESULTS: With regard to the quality indicator "Lethality in community-acquired pneumonia", it is possible to identify those cases that need to be included in quality assurance analysis by using predefined diagnosis lists. Risk adjustment can likewise be done according to the requirements set forth by the Federal Quality Assurance Office (Bundesgeschäftsstelle Qualitätssicherung, BQS), using only those data routinely collected for billing purposes. The results obtained are comparable to state and federal benchmark data. In addition, the analysis shows that the S3 recommendation to measure breathing rate as part of pneumonia risk assessment is not sufficiently being practiced at the moment. CONCLUSIONS: Risk-adjusted quality indicators can be generated from routine billing data according to section 21 KHEntG. Taking the patients' medical records as a reference, these indicators can even be shown to be more valid than those generated from BQS quality assurance data at the University Medical Center Ulm.
Assuntos
Reembolso de Seguro de Saúde/legislação & jurisprudência , Reembolso de Seguro de Saúde/estatística & dados numéricos , Sistemas Computadorizados de Registros Médicos/legislação & jurisprudência , Pneumonia Bacteriana/mortalidade , Medição de Risco/métodos , Análise de Sobrevida , Infecções Comunitárias Adquiridas/epidemiologia , Interpretação Estatística de Dados , Bases de Dados Factuais/legislação & jurisprudência , Alemanha/epidemiologia , Humanos , Fatores de RiscoRESUMO
PURPOSE: To assess interobserver agreement (IOA) in the diagnosis of pulmonary infiltrates on chest x-rays for patients with community-acquired pneumonia (CAP). MATERIALS AND METHODS: From 7/2002 to 12/2005, 806 adults with CAP were included in the multicenter study "CAPNETZ" (7 hospitals). Inclusion criteria were clinical signs of pneumonia and pulmonary opacification on chest x-rays. Each x-ray was reevaluated by two radiologists from the university hospital in consensus reading against the interpreter at the referring hospital in regard to: presence of infiltrate (yes/no/equivocal), transparency (
Assuntos
Infecções Comunitárias Adquiridas/diagnóstico por imagem , Pneumonia Bacteriana/diagnóstico por imagem , Radiografia Torácica , Adulto , Infecções Comunitárias Adquiridas/epidemiologia , Alemanha/epidemiologia , Humanos , Variações Dependentes do Observador , Pneumonia Bacteriana/classificação , Pneumonia Bacteriana/epidemiologiaRESUMO
Bley is one of the pharmacists who is nearly forgotten today. His scientific work is very extensive and diversified (535 paper in 12 scientific journals). The present article gives a short biography and shows Bley contributions in the field of technological development (for example using of sugarbeet) in Germany in the 19th century.