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[PMID]:29348126
[Au] Autor:Dendukuri N; Schiller I; de Groot J; Libman M; Moons K; Reitsma J; van Smeden M
[Ad] Endereço:Division of Clinical Epidemiology, McGill University Health Centre-Research Institute, Canada.
[Ti] Título:Concerns about composite reference standards in diagnostic research.
[So] Source:BMJ;360:j5779, 2018 01 18.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Pesquisa Biomédica/normas
Acurácia dos Dados
Grupos Diagnósticos Relacionados/normas
[Mh] Termos MeSH secundário: Viés
Padrões de Referência
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5779


  2 / 10304 MEDLINE  
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[PMID]:29425014
[Au] Autor:Watzlaf V; Nemchik S; Hoerner M; Sheridan P
[Ti] Título:ICD-10 Coding Productivity Study Highlights Emerging Standards.
[So] Source:J AHIMA;87(8):44-7, 2016 08.
[Is] ISSN:1060-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Codificação Clínica/normas
Eficiência
Classificação Internacional de Doenças
Controle de Qualidade
[Mh] Termos MeSH secundário: Grupos Diagnósticos Relacionados
Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


  3 / 10304 MEDLINE  
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[PMID]:29424976
[Ti] Título:The Evolution of DRGs (2017 Update).
[So] Source:J AHIMA;88(6):48-51, 2017 06.
[Is] ISSN:1060-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Grupos Diagnósticos Relacionados/tendências
[Mh] Termos MeSH secundário: Centers for Medicare and Medicaid Services (U.S.)
Codificação Clínica
Seres Humanos
Classificação Internacional de Doenças
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


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[PMID]:28464134
[Au] Autor:Odutayo A; Copsey B; Dutton S; Cook J; Hopewell S; Altman DG
[Ad] Endereço:Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom.
[Ti] Título:Characteristics and Dissemination of Phase 1 Trials Approved by a UK Regional Office in 2012.
[So] Source:JAMA;317(17):1799-1801, 2017 05 02.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ensaios Clínicos Fase I como Assunto/estatística & dados numéricos
Disseminação de Informação/métodos
Preparações Farmacêuticas/administração & dosagem
[Mh] Termos MeSH secundário: Ensaios Clínicos Fase I como Assunto/métodos
Grupos Diagnósticos Relacionados
Seres Humanos
Projetos de Pesquisa
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Pharmaceutical Preparations)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.1471


  5 / 10304 MEDLINE  
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Texto completo SciELO Colômbia
Texto completo SciELO Saúde Pública
[PMID]:28453037
[Au] Autor:Gorbanev I; Agudelo-Londoño S; Cortes A; Yepes FJ
[Ad] Endereço:Pontificia Universidad Javeriana, Bogotá, Colombia, ariel.cortes@javeriana.edu.co.
[Ti] Título:[Innovative culture and diagnosis related groups in a high complexity hospital, Colombia].
[Ti] Título:Cultura innovadora y grupos relacionados de diagnóstico en un hospital de alta complejidad, Colombia..
[So] Source:Rev Salud Publica (Bogota);18(2):251-262, 2016 Apr.
[Is] ISSN:0124-0064
[Cp] País de publicação:Colombia
[La] Idioma:spa
[Ab] Resumo:Objectives To characterize the perception of Diagnosis-Related Groups (DRGs) as an innovation among physicians, nurses and administrative staff in a hospital in Colombia. Methods A case study of innovative culture in a hospital. Surveys and focus groups were carried out with the medical, nursing and administrative staff. Descriptive statistics were calculated for the perceptions of innovative culture. Comparative analysis was done between professional groups. The results of the focus groups were transcribed and analyzed to deepen the findings of the surveys. Results Significant differences were found in perceptions of the innovative culture. The nursing staff were more enthusiastic than doctors when evaluating the innovative culture and leadership. Physicians felt more autonomy when discussing professional issues. Administrative staff assessed the Hospital's disposition to acquire new medical technologies as higher than that of physicians. The three groups know little about DRG's. Conclusions When implementing a health innovation it is advisable to analyze its effect on the professionals who participate in the implementation. Physicians perceive DRGs as a threat to their professional autonomy, while nurses see it as a pro-innovation force. It is important to involve nursing and administrative staff when implementing this kind of innovation.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Grupos Diagnósticos Relacionados
Administradores Hospitalares
Corpo Clínico Hospitalar
Recursos Humanos de Enfermagem no Hospital
Inovação Organizacional
[Mh] Termos MeSH secundário: Colômbia
Grupos Focais
Seres Humanos
Autonomia Profissional
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29341569
[Au] Autor:Mihailovic N; Trajkovic G; Simic-Vukomanovic I; Ristic S; Kocic S
[Ti] Título:Agreement between admission and discharge diagnoses: Analysis by the groups of international classification of diseases, 10th revision.
[So] Source:Vojnosanit Pregl;73(12):1125-31, 2016 Dec.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: Admission diagnosis represents the diagnosis of an illness, injury or condition due to which a patient is referred to hospital to be admitted. Discharge diagnosis represents the main reason of illness or condition due to which a patient is admitted. The aim of this study was to analyze the agreement between admission diagnostic groups and discharge diagnostic groups of patients in the Clinical Center Kragujevac in the period from January 1, 2006 to December 31, 2013 on the basis of the hospitalization report. Methods: From the basic set of reports, 5% of random samples were singled out and they contained 20,422 reports. Out of the given number of reports, 18,173 hospitalization reports were complete and then further analyzed in the paper. Admission diagnostic groups given by the primary care doctor were compared with discharge diagnostic groups filled out by the practicing physician in the hospital ward from which a patient was discharged. The agreement of these two diagnostic groups was an indication of the high-quality performance of the primary care doctor. Agreement analysis was conducted using Cohen's Kappa statistics. Restuls: Agreement analysis showed that the values of the Kappa coefficient for the five leading admission diagnostic groups were in the range of κ = 0.61 to κ = 0.94. The values of the Kappa coefficient for the five most common discharge diagnostic groups were in the range of κ = 0.55 to κ = 0.81. Conclusion: Hospitalization report is a reliable individual report on inpatient care, so it could be used in determining the degree of agreement between admission diagnostic groups and discharge diagnostic groups.
[Mh] Termos MeSH primário: Classificação Internacional de Doenças
Admissão do Paciente
Alta do Paciente
[Mh] Termos MeSH secundário: Adulto
Idoso
Grupos Diagnósticos Relacionados
Feminino
Seres Humanos
Tempo de Internação
Masculino
Meia-Idade
Variações Dependentes do Observador
Sumários de Alta do Paciente Hospitalar
Valor Preditivo dos Testes
Reprodutibilidade dos Testes
Estudos Retrospectivos
Sérvia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150427057M


  7 / 10304 MEDLINE  
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[PMID]:29206990
[Au] Autor:Mongin SJ; Baron SL; Schwartz RM; Liu B; Taioli E; Kim H
[Ti] Título:Measuring the Impact of Disasters Using Publicly Available Data: Application to Hurricane Sandy (2012).
[So] Source:Am J Epidemiol;186(11):1290-1299, 2017 Dec 01.
[Is] ISSN:1476-6256
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The unexpected nature of disasters leaves little time or resources for organized health surveillance of the affected population, and even less for those who are unaffected. An ideal epidemiologic study would monitor both groups equally well, but would typically be decided against as infeasible or costly. Exposure and health outcome data at the level of the individual can be difficult to obtain. Despite these challenges, the health effects of a disaster can be approximated. Approaches include 1) the use of publicly available exposure data in geographic detail, 2) health outcomes data-collected before, during, and after the event, and 3) statistical modeling designed to compare the observed frequency of health outcomes with the counterfactual frequency hidden by the disaster itself. We applied these strategies to Hurricane Sandy, which struck the northeastern United States in October 2012. Hospital admissions data from the state of New York with information on primary payer as well as patient demographic characteristics were analyzed. To illustrate the method, we present multivariate logistic regression results for the first 2 months after the hurricane. Inferential implications of admissions data on nearly the entire target population in the wake of a disaster are discussed.
[Mh] Termos MeSH primário: Tempestades Ciclônicas/estatística & dados numéricos
Desastres/estatística & dados numéricos
Exposição Ambiental/efeitos adversos
Serviços de Saúde/utilização
Nível de Saúde
Saúde Mental
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Pré-Escolar
Grupos Diagnósticos Relacionados/estatística & dados numéricos
Exposição Ambiental/estatística & dados numéricos
Feminino
Seres Humanos
Lactente
Recém-Nascido
Modelos Logísticos
Masculino
Registros Médicos/estatística & dados numéricos
Meia-Idade
New York/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171213
[Lr] Data última revisão:
171213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1093/aje/kwx194


  8 / 10304 MEDLINE  
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Texto completo SciELO Brasil
[PMID]:28977197
[Au] Autor:Carmona F; Manso PH; Ferreira MN; Ikari NM; Jatene MB; Amato L; Turquetto AL; Caneo LF
[Ad] Endereço:Hospital das Clinicas of Faculdade de Medicina de Ribeirão Preto of Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
[Ti] Título:Collaborative Quality Improvement in the Congenital Heart Defects: Development of the ASSIST Consortium and a Preliminary Surgical Outcomes Report.
[So] Source:Braz J Cardiovasc Surg;32(4):260-269, 2017 Jul-Aug.
[Is] ISSN:1678-9741
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: ASSIST is the first Brazilian initiative in building a collaborative quality improvement program in pediatric cardiology and congenital heart disease. The purposes of this manuscript are: (a) to describe the development of the ASSIST project, including the historical, philosophical, organizational, and infrastructural components that will facilitate collaborative quality improvement in congenital heart disease care; (b) to report past and ongoing challenges faced; and (c) to report the first preliminary data analysis. METHODS: A total of 614 operations were prospectively included in a comprehensive online database between September 2014 and December 2015 in two participating centers. Risk Adjustment for Congenital Heart Surgery (RACHS) 1 and Aristotle Basic Complexity (ABC) scores were obtained. Descriptive statistics were provided, and the predictive values of the two scores for mortality were calculated by multivariate logistic regression models. RESULTS: Many barriers and challenges were faced and overcome. Overall mortality was 13.4%. Independent predictors of in-hospital death were: RACHS-1 categories (3, 4, and 5/6), ABC level 4, and age group (≤ 30 days, and 30 days - 1 year). CONCLUSION: The ASSIST project was successfully created over a solid base of collaborative work. The main challenges faced, and overcome, were lack of institutional support, funding, computational infrastructure, dedicated staff, and trust. RACHS-1 and ABC scores performed well in our case mix. Our preliminary outcome analysis shows opportunities for improvement.
[Mh] Termos MeSH primário: Cardiopatias Congênitas/cirurgia
Avaliação de Processos e Resultados (Cuidados de Saúde)/organização & administração
Melhoria de Qualidade/organização & administração
[Mh] Termos MeSH secundário: Adolescente
Brasil
Criança
Pré-Escolar
Grupos Diagnósticos Relacionados/estatística & dados numéricos
Feminino
Cardiopatias Congênitas/mortalidade
Mortalidade Hospitalar
Seres Humanos
Lactente
Recém-Nascido
Masculino
Estudos Multicêntricos como Assunto/métodos
Valor Preditivo dos Testes
Avaliação de Programas e Projetos de Saúde
Estudos Prospectivos
Risco Ajustado/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE


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[PMID]:28911128
[Au] Autor:Liu R; Shi J; Yang B; Jin C; Sun P; Wu L; Yu D; Xiong L; Wang Z
[Ad] Endereço:Department of Health Service Management, Second Military Medical University, Shanghai 200433, China.
[Ti] Título:Charting a path forward: policy analysis of China's evolved DRG-based hospital payment system.
[So] Source:Int Health;9(5):317-324, 2017 Sep 01.
[Is] ISSN:1876-3405
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: At present, the diagnosis-related groups-based prospective payment system (DRG-PPS) that has been implemented in China is merely a prototype called the simplified DRG-PPS, which is known as the 'ceiling price for a single disease'. Given that studies on the effects of a simplified DRG-PPS in China have usually been controversial, we aim to synthesize evidence examining whether DRGs can reduce medical costs and length of stay (LOS) in China. Methods: Data were searched from both Chinese [Wan Fang and China National Knowledge Infrastructure Database (CNKI)] and international databases (Web of Science and PubMed), as well as the official websites of Chinese health departments in the 2004-2016 period. Only studies with a design that included both experimental (with DRG-PPS implementation) and control groups (without DRG-PPS implementation) were included in the review. Results: The studies were based on inpatient samples from public hospitals distributed in 12 provinces of mainland China. Among them, 80.95% (17/21) revealed that hospitalization costs could be reduced significantly, and 50.00% (8/16) indicated that length of stay could be decreased significantly. In addition, the government reports showed the enormous differences in pricing standards and LOS in various provinces, even for the same disease. Conclusions: We conclude that the simplified DRGs are useful in controlling hospitalization costs, but they fail to reduce LOS. Much work remains to be done in China to improve the simplified DRG-PPS.
[Mh] Termos MeSH primário: Grupos Diagnósticos Relacionados
Economia Hospitalar
Formulação de Políticas
Sistema de Pagamento Prospectivo
[Mh] Termos MeSH secundário: China
Hospitalização/economia
Seres Humanos
Tempo de Internação/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170916
[St] Status:MEDLINE
[do] DOI:10.1093/inthealth/ihx030


  10 / 10304 MEDLINE  
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[PMID]:28866973
[Au] Autor:McClean K; Mullany D; Huckson S; van Lint A; Chavan S; Hicks P; Hart G; Paul E; Pilcher D
[Ad] Endereço:Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, Australia.
[Ti] Título:Identification and assessment of potentially high-mortality intensive care units using the ANZICS Centre for Outcome and Resource Evaluation clinical registry.
[So] Source:Crit Care Resusc;19(3):230-238, 2017 Sep.
[Is] ISSN:1441-2772
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:PURPOSE: A hospital's highest-risk patients are managed in the intensive care unit. Outcomes are determined by patients' severity of illness, existing comorbidities and by processes of care delivered. The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation (CORE) manages a binational clinical registry to benchmark performance, and report and assess ICUs which appear to have worse outcomes than others. METHODS: A descriptive retrospective cohort study was undertaken to detail processes, outcomes, limitations and practical lessons learnt from monitoring ICU performance throughout Australia and New Zealand. All ICUs contributing to the ANZICS Adult Patient Database between 2009 and 2014 were included. A potential outlier ICU was defined as one with a statistically significantly higher standardised mortality ratio (SMR) than its peer group. RESULTS: There were 757 188 admissions to 168 ICUs. Of these, 27 ICUs (16%) were identified as potential outlier ICUs at least once. Data quality problems led to inaccurate or artificially elevated SMRs at 16/27 ICUs. Variation in diagnostic casemix partly or completely explained the elevated SMR at 15/27 ICUs. At nine ICUs where data quality and casemix differences did not explain the elevated SMR, process-of-care problems were identified. CONCLUSIONS: A combination of routine monitoring techniques, statistical analysis and contextual interpretation of findings is required to ensure potential outlier ICUs are appropriately identified. This ensures engagement and understanding from clinicians and jurisdictional health departments, while contributing to the improvement of ICU practices throughout Australia and New Zealand.
[Mh] Termos MeSH primário: Mortalidade Hospitalar
Unidades de Terapia Intensiva
Qualidade da Assistência à Saúde
Sistema de Registros
[Mh] Termos MeSH secundário: Austrália
Benchmarking
Bases de Dados Factuais
Grupos Diagnósticos Relacionados
Seres Humanos
Nova Zelândia
Avaliação de Processos e Resultados (Cuidados de Saúde)
Estudos Retrospectivos
Sociedades Médicas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170905
[St] Status:MEDLINE



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