Practice variations, chance and quality of care.

نویسندگان

  • J M Brophy
  • L Joseph
چکیده

In this issue Dr. William A. Ghali and colleagues publish their provocative study of Canadian (excluding Quebec) rates of in-hospital death after coronary artery bypass grafting (CABG) for the period 1992/93 to 1995/96 (page 926). For 50 357 CABG cases, they observed an overall rate of in-hospital death of 3.6%. After adjustment for sociodemographic factors, coexisting conditions and disease severity, the rate of in-hospital death ranged from 1.95% to 5.76%. The authors suggest that there may be clinically meaningful differences in the quality of care among the 23 institutions studied. However, partly because of the uncertainties in the methodology, the authors do not favour public disclosure of the findings for individual hospitals. Some salient points merit further discussion.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis: A Chance for a Multidisciplinary Treatment Approach

Background and Objectives: Idiopathic pulmonary fibrosis (IPF) is characterized by progressively worsening lung function, ventilation capacity, dyspnea, and finally reduced exercise intolerance. All of these have a significant negative impact on functional capacity and quality of life. In this study, we aim to evaluate the effects of pulmonary rehabilitation (PR) in IPF and assess the predictor...

متن کامل

Assessment of knowledge and quality of practice of proper foot care in Iranian patients with type 2 diabetes

Background: Uncontrolled diabetes can lead to a high rate of complications. Diabetic foot ulcer (DFU), leading to significant morbidity. However, DFU can be prevented and managed through education of patient foot care. Objectives: The current study aimed to evaluate the knowledge and practice routines of patients with type 2 diabetes (T2DM) regarding foot care. Methods: A questionnaire was de...

متن کامل

Healthcare Reimbursement and Quality Improvement: Integration Using the Electronic Medical Record; Comment on “Fee-for-service Payment - an Evil Practice That Must Be Stamped Out?”

Reimbursement for healthcare has utilized a variety of payment mechanisms with varying degrees of effectiveness. Whether these mechanisms are used singly or in combination, it is imperative that the resulting systems remunerate on the basis of the quantity, complexity, and quality of care provided. Expanding the role of the electronic medical record (EMR) to monitor provider practice, patient r...

متن کامل

The Relationship Between the Scope of Essential Health Benefits and Statutory Financing: An International Comparison Across Eight European Countries

Background Both rising healthcare costs and the global financial crisis have fueled a search for policy tools in order to avoid unsustainable future financing of essential health benefits. The scope of essential health benefits (the range of services covered) and depth of coverage (the proportion of costs of the covered benefits that is covered publicly) are corresponding variables in determini...

متن کامل

Explaining the Concept of Ethics in Home Health Care Nursing: Content Analysis

Introduction: Adherence of home care nurses to ethics in care, while improving the quality of nursing care, also improves patient satisfaction. Therefore, nurses must have ethical in care competency. The purpose of this study is to explain of ethical competency in care at home. Methods: The qualitative content analysis study is conventional that was conducted in home health care centers in Tehr...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

دوره 159 8  شماره 

صفحات  -

تاریخ انتشار 1998