https://scholars.lib.ntu.edu.tw/handle/123456789/582673
標題: | Risk-adjusted rates between hospitals for adverse outcomes of very-low-birth-weight infants | 作者: | Chen T.-T. Tsou K.-I. Jim W. CHI-NIEN CHEN |
關鍵字: | Morbidity; Mortality; Premature birth; Risk adjustment | 公開日期: | 2021 | 出版社: | Elsevier B.V. | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: To analyze the amount of variation in these risk-adjusted adverse outcomes corresponding to the care of premature births. In addition, hospitals were ranked according to their unadjusted and adjusted rates, and we assessed the degree of concordance between these rankings. Finally, the correlations of hospital-adjusted adverse outcomes were also tested. Methods: The study utilized the 5-year Taiwan Premature Infant Follow-up Network (TPFN) database in Taiwan from 2014 to 2018, and the sample size was 6482. We calculated the “observed over expected” (OE) ratio every year to form the risk-adjusted adverse outcome rate for each hospital. Results: There was a larger variation in the risk-adjusted rate for NEC and the second-largest variation for IVH. Regarding the concordances between the unadjusted and adjusted ranks, the ranks for mortality had the lowest concordance (coefficient of concordance 0.64), and only a few of the risk-adjusted rates between outcomes were significantly correlated. Conclusion: The results of the TPFN show that there is room to improve performance in terms of large variations in NEC and IVH. Furthermore, risk adjustment is important, especially for mortality, since the ranks for mortality have the lowest concordance. Finally, we cannot generate a conclusion regarding whether a hospital is high in quality if we only take 1 or 2 adverse outcomes as profiling measures because only a few of the risk-adjusted rates between outcomes were significantly correlated. ? 2021 Formosan Medical Association |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85105351390&doi=10.1016%2fj.jfma.2021.03.033&partnerID=40&md5=4730d9ae17e7ec1e46b3ddc2aa131613 https://scholars.lib.ntu.edu.tw/handle/123456789/582673 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2021.03.033 | SDG/關鍵字: | steroid; adverse outcome; Apgar score; Article; birth weight; brain hemorrhage; congenital malformation; disease severity; female; follow up; gestational age; hospital; human; lung dysplasia; major clinical study; male; necrotizing enterocolitis; newborn; newborn care; newborn morbidity; newborn mortality; newborn sepsis; outcome assessment; preeclampsia; premature fetus membrane rupture; prematurity; prenatal care; retrolental fibroplasia; risk assessment; small for date infant; steroid therapy; Taiwan; tertiary care center; vaginal delivery; very low birth weight; epidemiology; infant; infant mortality; pregnancy; prematurity; Female; Hospitals; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Pregnancy; Taiwan |
顯示於: | 醫學系 |
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