Evaluating the Patient Safety Indicators - How well do they perform on Veterans Health Administration data?
Evaluating the Patient Safety Indicators - How well do they perform on Veterans Health Administration data?
复制标题
DOI：
10.1097/01.mlr.0000173561.79742.fb
复制
发表时间：
2005-09-01
期刊：
影响因子：
3
通讯作者：
Romano, PS
中科院分区：
文献类型：
--
作者：
Rosen, AK;Rivard, P;Romano, PS
背景资料：患者安全指标（Patient Safety Indicators，PSI）是由美国医疗保健研究和质量局（Agency for Healthcare Research and Quality）开发的一种基于数据的管理工具，越来越多地用于筛查潜在的住院患者安全问题。虽然退伍军人健康管理局（VA）是一个国家的领导者在病人安全，准确的信息流行病学的病人安全事件在VA.Objectives：我们的目标是：（1）应用AHRQ PSI软件VA管理数据，以确定潜在的情况下，妥协的病人安全;（2）确定发生率的PSI事件在VA;（3）检验PSIs的结构效度。方法：我们检验了VA中观察到的PSI率和风险调整后的PSI率之间的差异，比较了VA和非VA PSI率，并通过检验PSIs与VA住院其他结局的相关性来检验PSIs的结构效度。我们在2001财年在全国范围内确定了11,411起PSI事件。每1000例出院观察到的PSI发生率范围从“输血反应”的0.007到“抢救失败”的155.5不等。“VA和非VA风险调整后的PSI率之间存在显著差异，尽管差异很小。与PSI事件住院时间较长，死亡率较高，和较高的成本比那些没有PSI events.Conclusions：我们的研究结果表明，PSI可能是有用的患者安全筛选工具，在VA。我们的PSI率与全国低发病率一致;然而，VA和非VA率之间的差异表明，不充分的病例组合调整可能有助于这些结果。
Background: The Patient Safety Indicators (PSIs), an administrative data-based tool developed by the Agency for Healthcare Research and Quality, are increasingly being used to screen for potential in-hospital patient safety problems. Although the Veterans Health Administration (VA) is a national leader in patient safety, accurate information on the epidemiology of patient safety events in the VA is still unavailable.Objectives: Our objectives were to: (1) apply the AHRQ PSI software to VA administrative data to identify potential instances of compromised patient safety; (2) determine occurrence rates of PSI events in the VA; and (3) examine the construct validity of the PSIs.Methods: We examined differences between observed and riskadjusted PSI rates in the VA, compared VA and non-VA PSI rates, and investigated the construct validity of the PSIs by examining correlations of the PSIs with other outcomes of VA hospitalizations.Results: We identified 11,411 PSI events in the VA nationwide in FY'01. Observed PSI rates per 1000 discharges ranged from 0.007 for "transfusion reaction" to 155.5 for "failure to rescue." There were significant, although small, differences between VA and non-VA risk-adjusted PSI rates. Hospitalizations with PSI events had longer lengths of stay, higher mortality, and higher costs than those without PSI events.Conclusions: Our results suggest that the PSIs may be useful as a patient safety screening tool in the VA. Our PSI rates were consistent with the national incidence of low rates; however, differences between VA and non-VA rates suggest that inadequate case-mix adjustment may be contributing to these findings.