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1.
Bull World Health Organ ; 98(3): 161-169, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-32132750

RESUMEN

Objective: To evaluate the effect of a disease management programme in Kazakhstan on quality indicators for patients with hypertension, diabetes and chronic heart failure. Methods: A supportive, interdisciplinary, quality improvement programme was implemented between November 2014 and November 2015 at seven polyclinics in Pavlodar and Petropavlovsk. Quality improvement teams were established at each clinic and quality improvement tools were introduced, including patient flowsheets, decision support tools, patient registries, a patient recall process, support for patient self-management and patient follow-up with intensity adjusted for level of disease control. Clinic teams met for four 3-day interactive learning sessions within 1 year, with additional coaching visits. Implementation was managed by five local coordinators and consultants trained by international consultants. National and regional steering committees monitored progress. Findings: Between July and October 2015, the proportion of hypertensive patients with the recommended blood pressure increased from 24% (101/424) to 56% (228/409). Among patients with diabetes, the proportion who recently underwent eye examinations increased from 26% (101/391) to 71% (308/433); the proportion who had their low-density lipoprotein cholesterol measured increased from 57% (221/391) to 85% (369/433); and the proportion who had their albumin : creatinine ratio measured increased from 11% (44/391) to 49% (212/433). The proportion of chronic heart failure patients who underwent echocardiography rose from 91% (128/140) to 99% (157/158). All patients set themselves self-management goals. Conclusion: This intensive, supportive, multifaceted programme was associated with significant improvements in quality of care for patients with chronic disease. Further investment in coaching capacity is needed to extend the programme nationally.


Asunto(s)
Diabetes Mellitus/terapia , Insuficiencia Cardíaca/terapia , Hipertensión/terapia , Calidad de la Atención de Salud , Autocuidado/normas , Enfermedad Crónica , Femenino , Humanos , Kazajstán , Masculino , Tutoría , Mejoramiento de la Calidad , Autocuidado/métodos
2.
Public Health Res Pract ; 30(1)2020 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-32152613

RESUMEN

Recent reports highlight an inconsistent provision of palliative and end-of-life (palliative) care across Australia, particularly in regional, rural and remote areas. Palliative care improves quality of life and the experience of dying, and all people should have equitable access to quality needs-based care as they approach and reach the end of their lives. A palliative approach to care is crucial in rural and remote Australia where there is a reliance for such care on generalist providers amid the challenges of a limited workforce, poorer access, and vast geography. This article describes the development and implementation of the Far West NSW Palliative and End-of-Life Model of Care, a systematic solution that could drive improvement in the provision of a quality palliative approach to care and support from any clinician in a timely manner, for patients, their families and carers anywhere.


Asunto(s)
Cuidados Paliativos/normas , Servicios de Salud Rural/estadística & datos numéricos , Cuidado Terminal/normas , Australia , Necesidades y Demandas de Servicios de Salud , Humanos , Calidad de la Atención de Salud , Calidad de Vida , Población Rural
3.
Stomatologiia (Mosk) ; 99(1): 82-85, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32125308

RESUMEN

AIM: Based on the comprehensive socio-economic study the analysis of the amount of dental and preventive care provided in terms of Compulsory Medical Insurance program has been made. MATERIAL AND METHODS: The study was based in six dental clinics of the Central Federal District of Russia, treating children and adults with the total amount of attached and insured patients equaled 170.000 in each. RESULTS: Visits for the purpose of prophylaxis make up 24.87±0.27% in the structure of all methods. Dental care specialists have conducted 25 413.0 prophylaxis admissions of their patients. 35 563.29 conventional units of labor input are elaborated on the total cost of 4 614 812.16 rubles. In the purpose of diseases prevention it is planned to spend the average of 0.21 conventional units of labor input on each insured citizen or 2.1 minute on the cost of 27.31 rubles. It was spent 0.51 conventional units of labor input or 5.1 minutes that costs 66,06 rubles for each patient. These data indicate the lack of funding and time to conduct quality preventive care. CONCLUSION: Dental diseases prophylaxis is at the low rate which is proved by the study results - only 0.19 visits with preventive purposes per one insured person. The total share of preventive services in the structure of all services, not including specialists, is 17.51±0.06%.


Asunto(s)
Accesibilidad a los Servicios de Salud , Calidad de la Atención de Salud , Adulto , Niño , Atención Odontológica , Hospitalización , Humanos , Federación de Rusia
4.
Artículo en Ruso | MEDLINE | ID: mdl-32119214

RESUMEN

The efficiency of quality control of medical care in medical organizations providing medical care in out-patient conditions is inadequate. The purpose of the study is to identify main problems of ensuring quality of medical care in private medical organizations providing medical care in out-patient conditions and to develop suggestions for their elimination. The assessment of medical care quality in private medical organizations network was carried out using expertise technique (n = 1070), intra-organizational attestation (n = 47), questionnaire survey of administrative (n = 28) and medical personnel (n = 241). The total number of medical care defects made up to 4,822, and 97.3% of them were related to diagnosis and treatment. A full justification of diagnosis was recorded in 65.8% of cases. The cases of insufficient and excessive examination have been identified. The non-compliance with duration of treatment and frequency of visits have been established. The inadequate medical efficiency (67.6%) reliably effected on low compliance of patients, recorded in 18.9% of cases (p < 0.05). The main problems of ensuring medical care quality are related to organization of internal control system, involvement and motivation of medical personnel and development and maintenance of necessary organizational culture. In the private health care sector, quality issues can be solved solely by means of material resources. It is necessary to improve of medical personnel management, internal quality control of medical care and management of organizational culture.


Asunto(s)
Prestación de Atención de Salud , Sector Privado , Calidad de la Atención de Salud , Personal de Salud , Humanos , Cultura Organizacional
5.
Br J Nurs ; 29(5): 324-325, 2020 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-32167818

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses two patient safety reports, which stress the importance of taking proper action when patient safety incidents occur.


Asunto(s)
Seguridad del Paciente , Calidad de la Atención de Salud , Medicina Estatal , Humanos , Medicina Estatal/normas , Reino Unido
6.
Georgian Med News ; (298): 159-165, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32141871

RESUMEN

Health systems provide health actions-activities to improve or maintain health. These actions take place in the context of and are influenced by political, cultural, social, and institutional factors. Demographic and socioeconomic makeup, including genetics and personal resources, affect the health status of individuals seeking care. Access to the health care system is required to obtain the care that maintains or improves health, but simple access is not enough; the system's capacities must be applied skillfully. Thus, quality means optimizing material inputs and practitioner skills to produce health. As the Institute of Medicine defines it, quality is "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." Globally, there is an acute shortage of human resources for health (HRH), and low-income countries bear the highest burden. This shortage has not only considerably constrained the achievement of health-related development goals but also impeded accelerated progress towards universal health coverage (UHC). Like any other low-income country, Georgia is experiencing a health workforce shortage, particularly in specialized healthcare workers to cater to the rapidly growing need for specialized health care (MOH Training Needs Assessment report (2015). The efficient use of the existing health workforce, including task shifting, is under consideration as a short-term stopgap measure. At the same time, deliberate efforts are being put on retention policies and increased production of HRH. The results of the analysis confirmed the essential leadership and managerial competencies for public hospital managers in Georgia. These competencies include Policy development and implementation, strategy development and orientation; plan-making; human resource management; financial management; equipment and infrastructure management, information management, risk and disaster management, self-management; quality management; investigation, supervision, monitoring and evaluation, ethics and knowledge. There are necessary competencies. Managers have to fulfill their tasks effectively and use them as a basis to develop competency-based training for the current management taskforce and preparing future hospital managers. This kind of study was limited before starting short and long term (including Master program Health Management and Administration) educational programs in different regions of Georgia. Thus, it should be further studied to gain an overall and clear picture of leadership and managerial competencies for hospital public managers. Taking into account the labor market flows in Georgia, to train and inspire a new generation of Health Administration professionals in global network atmosphere, provide broad knowledge, skills and expertise that is needed to undertake leadership roles in addressing critical issues of Health Administration at the national and global level is an urgent need. For this purpose, the elaboration and implementation of student-centered and competence-oriented Georgian-USA Collaborative Master Program in Health Administration with our future activities will be a relevant approach.


Asunto(s)
Personal Administrativo , Prestación de Atención de Salud/organización & administración , Administración de Instituciones de Salud/normas , Personal de Salud , Calidad de la Atención de Salud/normas , Cobertura Universal del Seguro de Salud , Georgia (República) , Humanos , Competencia Profesional
7.
Rev Bras Epidemiol ; 23: e200014, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32159625

RESUMEN

INTRODUCTION: Primary health care must assume the centrality of care so that health systems address and solve the health needs of the population. OBJECTIVE: To evaluate the quality of primary health care from the perspective of health professionals, including those associated with the Mais Médicos Brasil Program, verifying associations between quality of services and professional qualification. METHODOLOGY: A cross-sectional study where interviews with health professionals were carried out. The quality of care was measured by means of interviews about the experience of doctors and nurses with the services, using the Primary Care Assessment Tool (PCATool-Brasil). The presence and the extension of the primary health care attributes of the Southwest II region of Goiás state, constituted by 10 municipalities, were investigated. RESULTS: The lowest APS Overall Score was for the first contact access attribute (3.71). The bivariate analysis showed statistical difference between the variables profession and the essential, derived and general scores. Doctors of the More Doctors Program had higher average scores (7,68 essential; 9,11 derivative; 8,04 general) when compared to other medical professionals and nurses. CONCLUSIONS: The findings highlight the importance of permanent evaluation of health services, especially primary care, due to its importance and centrality to the organization of other levels of care. Only from this monitoring is possible a better management orientation for strategic and resolutive investments.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Atención Primaria de Salud/normas , Garantía de la Calidad de Atención de Salud/métodos , Calidad de la Atención de Salud , Educación Vocacional , Brasil , Estudios Transversales , Humanos , Médicos
8.
Rev Saude Publica ; 54: 21, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32049211

RESUMEN

OBJECTIVE: This study aims to assess the development and the validity analysis of the Assessment of Risk Management in Health Care Questionnaire (AGRASS). METHODS: This is a validation study of a measurement instrument following the stages: 1) Development of conceptual model and items; 2) Formal multidisciplinary assessment; 3) Nominal group for validity analysis with national specialists; 4) Development of software and national pilot study in 62 Brazilian hospitals 5) Delphi for validity analysis with the users of the questionnaire. In stages 3 and 5, the items were judged based on face validity, content validity, and utility and viability, by a 1-7 Likert scale (cut-off point: median < 6). Accuracy and reliability of the questionnaire were analyzed with the Confirmatory Factor Analysis and the Cronbach's alpha. RESULTS: The initial version of the instrument (98 items) was adapted during stages 1 to 3 for the final version with 40 items, which were considered relevant, of adequate content, useful, and viable. The instrument has 2 dimensions and 9 subdimensions, and the items have closed-ended questions (yes or no). The software for the automatic collection and analysis generates indicators, tables, and automatic graphs for the assessed institution and aggregated data. The adjustment indices confirmed a bi-dimensional model composed of structure and process (X2/gl = 1.070, RMSEA ≤ 0.05 = 0.847, TLI = 0.972), with high reliability for the AGRASS Questionnaire (α = 0.94) and process dimension (α = 0.93), and adequate for the structural dimension (α = 0.70). CONCLUSIONS: The AGRASS Questionnaire is a potentially useful instrument for the surveillance and monitoring of the risk management and patient safety in health services.


Asunto(s)
Seguridad del Paciente/normas , Calidad de la Atención de Salud/normas , Gestión de Riesgos/métodos , Encuestas y Cuestionarios/normas , Adulto , Brasil , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Reproducibilidad de los Resultados , Gestión de Riesgos/normas
9.
Br J Nurs ; 29(4): 250-251, 2020 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-32105535

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent patient reports and crisis events.


Asunto(s)
Informes Anuales como Asunto , Seguridad del Paciente , Medicina Estatal/legislación & jurisprudencia , Comités Consultivos , Femenino , Humanos , Servicios de Salud Materna/normas , Embarazo , Calidad de la Atención de Salud , Medicina Estatal/normas , Reino Unido
10.
J Nurs Adm ; 50(3): 152-158, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32040052

RESUMEN

OBJECTIVE: The aim of this study was to describe the complex relationships among patient safety culture, nurse demographics, advocacy, and patient outcomes. BACKGROUND: Why has healthcare lagged behind other industries in improving quality? Little nursing research exists that explores the multifactorial relationships that impact quality. METHODS: A convenience sample of 1045 nurses from 40 medical/surgical units was analyzed using a correlational cross-sectional design with secondary data analysis. Data sources included survey results for patient safety culture, nurse perceptions of patient advocacy, and patient experience and fall and pressure ulcer rates. RESULTS: Significant findings included a positive correlation between patient safety culture and advocacy and a negative correlation between safety culture, advocacy, and years of experience as a nurse. No significant correlations were found between safety culture and patient outcomes or advocacy and patient outcomes. CONCLUSIONS: Newer nurses were more positive about safety culture and advocacy, whereas experienced nurses were overall less positive.


Asunto(s)
Personal de Enfermería en Hospital/normas , Cultura Organizacional , Seguridad del Paciente/normas , Atención Dirigida al Paciente/normas , Conducta Cooperativa , Estudios Transversales , Humanos , Relaciones Interprofesionales , Calidad de la Atención de Salud , Estados Unidos
11.
J Nurs Adm ; 50(3): 128-134, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32049700

RESUMEN

Nurses need training and mentoring to lead evidence-based practice (EBP) improvements. An array of roles have been reported to have a positive impact on EBP adoption. A training program was created to assist point-of-care nurses and nurse leader partners in operationalizing the EBP Change Champion role to address priority quality indicators. The program, a case exemplar, and lessons learned are described with implications for leaders responsible for promoting EBP to improve quality care.


Asunto(s)
Práctica Clínica Basada en la Evidencia/educación , Liderazgo , Personal de Enfermería en Hospital/educación , Calidad de la Atención de Salud/normas , Conocimientos, Actitudes y Práctica en Salud , Humanos , Evaluación de Programas y Proyectos de Salud
12.
J Nurs Adm ; 50(3): 120-121, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32068620

RESUMEN

Innovations in patient care, nursing, and the practice environment are the hallmark of Magnet organizations. Establishing new ways of achieving high-quality care is the result of transformational leadership, empowering structures and processes, and exemplary professional practice in nursing. From coast to coast, clinical nurses take advantage of these opportunities to change care for the better, improve the patient experience, and drive the science of nursing forward. American Nurses Credentialing Center's National Magnet Nurse of the Year Awards recognize and reward this work. Five outstanding clinical nurses are honored, 1 in each of the Magnet Model components: transformational leadership; structural empowerment; exemplary professional practice; new knowledge, innovations, and improvements; and empirical outcomes. This month's Magnet Perspectives column spotlights the 2019 award winners and their achievements and examines how Magnet environments support and encourage their success.


Asunto(s)
Distinciones y Premios , Liderazgo , Servicio de Enfermería en Hospital/normas , Personal de Enfermería en Hospital/normas , Pautas de la Práctica en Enfermería/normas , Calidad de la Atención de Salud/normas , Humanos , Cultura Organizacional , Estados Unidos
13.
J Forensic Nurs ; 16(1): 55-60, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32068678

RESUMEN

Sexual assault victimization is a traumatic experience for children and youth, and care of survivors requires a trauma-informed approach. Children and youth with developmental disabilities are sexually victimized at higher rates than those without disabilities. Children with autism spectrum disorder (ASD), in particular, may be at an increased risk for both traumatic events and developing traumatic sequelae after sexual assault victimization. In this report, we present the case of a youth with ASD who sought acute sexual assault care, but whose care was compromised because of multiple systems failures, including gaps in communication regarding her unique needs, and inconsistent knowledge among multidisciplinary team members regarding necessary adaptations in the implementation of trauma-informed care for youth with ASD. Lessons learned, including proposed solutions to improve communication and education, and approaches to prevent unintended retraumatization are discussed.


Asunto(s)
Trastorno del Espectro Autista , Víctimas de Crimen , Atención Dirigida al Paciente/organización & administración , Delitos Sexuales , Adolescente , Comunicación , Femenino , Necesidades y Demandas de Servicios de Salud , Humanos , Grupo de Atención al Paciente , Calidad de la Atención de Salud
14.
J Glob Health ; 10(1): 010501, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32082545

RESUMEN

Background: Reductions in neonatal mortality remain stagnant, despite gains in health care access and utilization. Nutrition interventions during antenatal care (ANC) and in the immediate postpartum period are associated with improved neonatal outcomes. Adjusting coverage estimates for the quality of care provided yields greater insight into health system performance and potential population health benefits of accessing care. In this cross-sectional study, we adjust maternity care coverage measures for quality of nutrition interventions to determine the impact on infant birth weight and breastfeeding. Methods: We used household data from the Malawi 2013-2014 Multiple Indicator Cluster Survey to assess use of maternal health services and direct observations of ANC and delivery from the 2013 Service Provision Assessment to measure nutrition interventions provided. We adjusted coverage measures combining self-reported utilization of care with the likelihood of receipt of nutrition interventions. Using adjusted log-linear regression, we estimated the associations of these nutrition quality-adjusted metrics with infant birthweight and immediate breastfeeding. Results: Health facility data provided over 2500 directly observed clinical encounters and household data provided 7385 individual reports of health care utilization and outcomes. Utilization of ANC and facility-delivery was high. Women received nutrition-related interventions considerably less often than they sought care: over the course of ANC women received a median of 1.6 interventions on iron, 1 instance of nutrition counseling, and 0.06 instances of breastfeeding counseling. Nutrition quality-adjusted ANC coverage was associated with a reduced risk of low birthweight (adjusted relative risk [ARR] 0.87, 95% confidence interval (CI) = 0.79, 0.96) and increased likelihood of immediate breastfeeding (ARR = 1.04, 95% CI = 1.02, 1.07); nutrition quality-adjusted post-delivery care was also associated with greater uptake of immediate breastfeeding (ARR = 1.08, 95% CI = 1.02, 1.14). Based on these models, delivering nutrition interventions consistently within the existing level of coverage would decrease population prevalence of low birthweight from 13.7% to 10.8% and increase population prevalence of immediate breastfeeding from 75.9% to 86.0%. Conclusions: Linking household survey data to health service provision assessments demonstrates that despite high utilization of maternal health services in Malawi, low provision of nutrition interventions is undermining infant health. Substantial gains in newborn health are possible in Malawi if quality of existing services is strengthened.


Asunto(s)
Servicios de Salud Materna/estadística & datos numéricos , Fenómenos Fisiologicos Nutricionales Maternos , Estudios Transversales , Femenino , Investigación sobre Servicios de Salud , Humanos , Malaui , Embarazo , Calidad de la Atención de Salud
15.
Epidemiol Psychiatr Sci ; 29: e104, 2020 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-32089149

RESUMEN

Person-centred care is at the core of a value-based health system. Its transformative potential is to enable and support key policy, planning and service developments across the system even when these go against the self-interest of individual major players. It offers a potent test for decision makers at all levels. It demands responses that are multi-level, empirically grounded, expert-informed and data-driven that must converge on the singularity of individuals in the places that they live. This requires different approaches that recognise, respect and reconcile two necessary but constitutionally disparate perspectives: the bureaucratic, overtly decontextualised, top-down, policy and planning objectives of central governments and the formally complex, dynamic and contextualised experience of individuals in the system. Conflating the latter with the former can lead unwittingly to a pervasive and reductive form of quasi-Taylorism that nearly always creates waste at the expense of value. This has parallel application in the treatment domain where outcomes are non-randomly clustered and partitioned by socioeconomic status, amplifying unwarranted variation by place that is striking in its magnitude and heterogeneity. In this paper, we propose that a combination of (1) relevant, local and sophisticated data planning, collection and analysis systems, (2) more detailed person-centred service planning and delivery and (3) system accountability through co-design and transparent public reporting of health system performance in a manner that is understandable, relevant, and locally applicable are all essential in ensuring planned and provided care is most appropriate to more than merely the 'average' person for whom the current system is built. We argue that only through a greater appreciation of healthcare as a complex adaptive (eco)system, where context is everything, and then utilising planning, analysis and management methodologies that reflect this reality is the way to achieve genuine person-centred care.


Asunto(s)
Servicios de Salud Mental/organización & administración , Atención Dirigida al Paciente , Calidad de la Atención de Salud , Adolescente , Prestación de Atención de Salud , Investigación sobre Servicios de Salud , Humanos , Trastornos Mentales/terapia
16.
Z Gerontol Geriatr ; 53(2): 138-144, 2020 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-32048012

RESUMEN

BACKGROUND: The majority of acute care hospitals are not prepared for people with dementia with acute diseases in need of treatment. This results in an increased likelihood of the personnel being overtaxed. Dementia is the most frequent reason that hospital personnel administer sedating medication and use restraining measures. OBJECTIVE: The aim of this study was to investigate factors that influence the (inappropriate) use of sedating medication and physical restraints for patients with dementia in acute care hospitals. METHODS: A non-randomized case control study, including two internal medicine wards was conducted in Hamburg, Germany. In the intervention group a special care concept was implemented focussing on patients with dementia, while the control group received regular care without a special dementia care concept. Logistic regression models were conducted to investigate associations between factors, such as age, severity of dementia, conspicuous behavior, Barthel index and type of treatment and the use of sedating medication and physical restraint measures. RESULTS: Challenging behavior (odds ratio, OR = 1.32) and treatment in the control group (OR=1.94) were significantly associated with the use of sedating medication. A low Barthel index, longer periods of hospitalization and treatment in the control group were significantly associated with a higher probability of the implementation of physical restraining measures. DISCUSSION: The use of sedating medication as well as physical restraining measures varied greatly between the intervention and control groups. This is in line with other studies that came to similar results and suggests that multiple components of special care concepts can explain these differences. These include architectonic design and spatial aspects as well as dementia-specific training of employees and an appropriate personnel complement. Such interventions can also reduce agitation and behavioral problems of patients. The avoidance of sedation and restraining measures is also positively associated with an increase in the quality of life of patients with dementia.


Asunto(s)
Demencia/terapia , Hipnóticos y Sedantes/uso terapéutico , Restricción Física , Estudios de Casos y Controles , Demencia/complicaciones , Alemania , Humanos , Prescripción Inadecuada , Calidad de la Atención de Salud , Calidad de Vida
19.
Br J Nurs ; 29(3): 174-175, 2020 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-32053432

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses a Healthwatch report showing that improvements need to take place in the way the NHS reports on patient complaints.


Asunto(s)
Satisfacción del Paciente , Medicina Estatal/organización & administración , Humanos , Cultura Organizacional , Seguridad del Paciente , Calidad de la Atención de Salud , Medicina Estatal/normas , Reino Unido
20.
Medicine (Baltimore) ; 99(3): e18770, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011467

RESUMEN

Discrepancies between clinical and autopsy diagnoses range from 30% to 37%. The significance of deontological examinations remains high. In the pursuit of proper evaluation of diagnostic discrepancies, the establishment of pathogenesis, the mechanism of death, and a correct diagnosis are of particular importance.A retrospective study of deontological examinations, aimed at the detection of medical errors and carried out by the State Forensic Medicine Service during the period 1989 to 2016, was performed. The clinical and autopsy data from 1007 cases were collected in compliance with the research protocol.The number of deontological examinations tends to increase. In 60% of cases, the deceased were men. Most cases were in the age group of 50 to 59 years. Most examinations were carried out in relation to improperly provided healthcare services and the patient's death in surgery, admission, intensive care and obstetrics-gynecology departments. In 13% of cases, the diagnosis did not coincide and, in 79% of cases, the diagnoses fully coincided. In 68% of cases, the medical error was disproved.The number of deontological examinations is increasing. In most cases, clinical and autopsy diagnoses fully matched. Incorrectly clinically diagnosed intracranial injuries were the most common diagnostic mistakes. The data are similar to the results of research in other countries and would be relevant to ensuring the prevention of medical mistakes and the improvement of healthcare quality.


Asunto(s)
Causas de Muerte , Errores Diagnósticos/estadística & datos numéricos , Medicina Legal/métodos , Errores Médicos/estadística & datos numéricos , Calidad de la Atención de Salud/estadística & datos numéricos , Autopsia , Femenino , Humanos , Lituania , Masculino , Estudios Retrospectivos
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