scholarly journals Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal

2017 ◽  
Vol 6 (5) ◽  
pp. e82 ◽  
Author(s):  
Marie-Annick Le Pogam ◽  
Catherine Quantin ◽  
Oliver Reich ◽  
Philippe Tuppin ◽  
Anne Fagot-Campagna ◽  
...  
Author(s):  
P. Alison Paprica ◽  
Michael Schull

ABSTRACTObjectivesHigh profile initiatives and reports highlight the potential benefits that could be realized by increasing access to health data, but do members of the general public share this view? The objective was to gain insight into the general public’s attitudes toward users and uses of administrative health data. ApproachIn fall 2015, four professionally-moderated focus groups with a total of 31 Ontario participants were conducted; two in Thunder Bay, two in Toronto. Participants were asked to review and comment on: general information about research based on linked administrative health data, a case study and models through which various users might use administrative health data. ResultsSupport for research based on linked administrative health data was strongest when people agreed with the purposes for which studies were conducted. The main concerns related to the security of personal data generally (e.g., Canada Revenue Agency hacking incidents were noted) and potentially inappropriate uses of health data, particularly by the private sector (e.g., strong reservations about studies done solely or primarily with a profit motive). Participants were reassured when provided with information about the process for removing or coding identifying information from health data, and about the oversight provided by the Information and Privacy Commissioner of Ontario. However, even when fully informed of privacy and security safeguards, participants still felt that risks unavoidably increase when there are more people and organizations accessing data. ConclusionsMembers of general public were generally supportive of research based on linked administrative health data but with conditions, particularly when the possibility of private sector research was discussed. Notably, and citing security concerns, focus group participants preferred models that had a limited number of individuals or organizations accessing data.


2007 ◽  
Vol 65 (1) ◽  
pp. 67-87 ◽  
Author(s):  
Peter E. Rivard ◽  
Stephen L. Luther ◽  
Cindy L. Christiansen ◽  
Shibei Zhao ◽  
Susan Loveland ◽  
...  

2014 ◽  
Vol 22 (1) ◽  
pp. 19-28 ◽  
Author(s):  
Andrew D Boyd ◽  
Young Min Yang ◽  
Jianrong Li ◽  
Colleen Kenost ◽  
Mike D Burton ◽  
...  

Abstract Reporting of hospital adverse events relies on Patient Safety Indicators (PSIs) using International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes. The US transition to ICD-10-CM in 2015 could result in erroneous comparisons of PSIs. Using the General Equivalent Mappings (GEMs), we compared the accuracy of ICD-9-CM coded PSIs against recommended ICD-10-CM codes from the Centers for Medicaid/Medicare Services (CMS). We further predict their impact in a cohort of 38 644 patients (1 446 581 visits and 399 hospitals). We compared the predicted results to the published PSI related ICD-10-CM diagnosis codes. We provide the first report of substantial hospital safety reporting errors with five direct comparisons from the 23 types of PSIs (transfusion and anesthesia related PSIs). One PSI was excluded from the comparison between code sets due to reorganization, while 15 additional PSIs were inaccurate to a lesser degree due to the complexity of the coding translation. The ICD-10-CM translations proposed by CMS pose impending risks for (1) comparing safety incidents, (2) inflating the number of PSIs, and (3) increasing the variability of calculations attributable to the abundance of coding system translations. Ethical organizations addressing ‘data-, process-, and system-focused’ improvements could be penalized using the new ICD-10-CM Agency for Healthcare Research and Quality PSIs because of apparent increases in PSIs bearing the same PSI identifier and label, yet calculated differently. Here we investigate which PSIs would reliably transition between ICD-9-CM and ICD-10-CM, and those at risk of under-reporting and over-reporting adverse events while the frequency of these adverse events remain unchanged.


2005 ◽  
Vol 71 (5) ◽  
pp. 406-413 ◽  
Author(s):  
Benjamin K. Poulose ◽  
Marie R. Griffin ◽  
Yuwei Zhu ◽  
Walter Smalley ◽  
William O. Richards ◽  
...  

Identifying risk factors for adverse events after bariatric surgery (BaS) can help define high-risk groups to improve patient safety. We calculated cumulative incidence of adverse events and identified risk factors for these events using validated surgical patient safety indicators (PSIs) developed by the Agency for Healthcare Research and Quality. BaS patients ≥18 years old were identified using the 2002 Nationwide Inpatient Sample. Cumulative incidence at discharge was calculated for accidental puncture or laceration (APL), pulmonary embolus or deep venous thrombosis (PE/DVT), and postoperative respiratory failure (RF). Factors predictive of these PSIs were identified. From 7,853,982 discharges, a national cohort of 69,490 BaS patients was identified. During BaS hospitalization, the cumulative incidences per 1000 discharges of APL, PE/DVT, and RF were 12.6, 3.4, and 7.3, respectively. Risk factors for APL included male gender (odds ratio [OR] 1.6, 95% confidence interval 1.1–2.3, P < 0.05) and age of 40–49 years (OR 1.6 [1.1–2.3], P < 0.05) compared to ages 18–39 years. Patients aged 50–59 years (OR 3.5 [1.6–7.7], P < 0.05) had a higher chance of PE/DVT compared to those 18–39 years. Male gender (OR 1.8 [1.1–2.9], P < 0.05), ages 40–49 (OR 2.1 [1.1–4.2], P < 0.05) and 50–59 (OR 3.8 [2.1–6.9], P < 0.05), a history of chronic lung disease (OR 1.7 [1.1–2.7], P < 0.05), and Medicare coverage compared to private insurance (OR 2.2 [1.2–3.8], P < 0.05) were predictive of RF. This study established national measures for BaS adverse events. Further, risk factors associated with adverse events varied by gender, age, insurance status, and comorbidity. Evaluation of these higher risk BaS groups is needed to improve patient safety.


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