Detecting Hospital Outliers in Post-Pancreatectomy Care Using Funnel Plots from 2009-2018 Based on Nationwide Medico-Administrative Data.
World J Surg
; 45(7): 2210-2217, 2021 07.
Article
em En
| MEDLINE
| ID: mdl-33821349
ABSTRACT
OBJECTIVES:
Our objective was to identify hospitals with unusual mortality rates for major pancreatectomies over a period of ten years using 30-day mortality data from the French national database.METHODS:
Data for all patients who underwent pancreatectomy were extracted from the national medico-economic database (Programme de Médicalisation des Systèmes d'Information). To identify quality outliers for each hospital, the observed-to-expected 30-day mortality rates were used as a quality indicator.RESULTS:
A total of 19 494 patients underwent a major pancreatectomy in France between January 2009 and December 2018. The overall 30-day mortality rate was 4.8% (n = 944). For the 2009-2014 period, the funnel plot showed that 10 of the 176 hospitals lie outside the central 95% region and 7 lie outside the central 99.8% region. For the 2015-2018 period, out of 176 hospitals, 6 lie outside the central 95% region and 2 lie outside the central 99.8% region. The change in standardized mortality ratios between 2009-2014 and 2015-2018 testing for differences from the overall change, they were there 4 hospitals lie outside the central 95% region and 0 lie outside the central 99.8% region.CONCLUSION:
Over time, the improvement in hospital quality was weak. This study suggests that there is a pressing need to reorganize the supply of care for pancreatic surgery in France.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Pancreatectomia
/
Hospitais
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
World J Surg
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
França