Dario Tedesco1, Tina Hernandez-Boussard2, Elisa Carretta1, Paola Rucci1, Maurizia Rolli3, Patrizio Di Denia3, Kathryn McDonald4, Maria Pia Fantini1. 1. Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy. 2. Stanford University School of Medicine, Biomedical Informatics, 1070 Arastradero #373, Stanford, CA 94305-5559, USA. 3. Rizzoli Orthopedic Institute, Via G.C. Pupilli, 1, 40136 Bologna, Italy. 4. Center for Health Policy, Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 94305-6019, USA.
Abstract
OBJECTIVE: To compare patient safety in major orthopedic procedures between an orthopedic hospital in Italy, and 26 US hospitals of similar size. DESIGN: Retrospective analysis of administrative data from hospital discharge records in Italy and Florida, USA, 2011-13. Patient Safety Indicators (PSIs) developed by the Agency for Healthcare Quality and Research were used to identify inpatient adverse events (AEs). We examined the factors associated with the development of each different PSI, taking into account known confounders, using logistic regression. SETTING: One Italian orthopedic hospital and 26 hospitals in Florida with ≥ 1000 major orthopedic procedures per year. PARTICIPANTS: Patients ≥ 18 years who underwent 1 of the 17 major orthopedic procedures, and with a length of stay (LOS) > 1 day. INTERVENTION: Patient Safety management between Italy and the USA. MAIN OUTCOME MEASURE: Patient Safety Indicators. RESULTS: A total of 14 393 patients in Italy (mean age = 59.8 years) and 131 371 in the USA (mean age = 65.4 years) were included. US patients had lower adjusted odds of developing a PSI compared to Italy for pressure ulcers (odds ratio [OR]: 0.21; 95% confidence interval [CI]: 0.10-0.45), hemorrhage or hematoma (OR: 0.42; CI 0.23-0.78), physiologic and metabolic derangement (OR: 0.08; CI 0.02-0.37). Italian patients had lower odds of pulmonary embolism/deep vein thrombosis (OR: 3.17; CI 2.16-4.67) compared to US patients. CONCLUSIONS: Important differences in patient safety events were identified across countries using US developed PSIs. Though caution about potential coding differences is wise when comparing PSIs internationally, other differences may explain AEs, and offer opportunities for cross-country learning about safe practices.
OBJECTIVE: To compare patient safety in major orthopedic procedures between an orthopedic hospital in Italy, and 26 US hospitals of similar size. DESIGN: Retrospective analysis of administrative data from hospital discharge records in Italy and Florida, USA, 2011-13. Patient Safety Indicators (PSIs) developed by the Agency for Healthcare Quality and Research were used to identify inpatient adverse events (AEs). We examined the factors associated with the development of each different PSI, taking into account known confounders, using logistic regression. SETTING: One Italian orthopedic hospital and 26 hospitals in Florida with ≥ 1000 major orthopedic procedures per year. PARTICIPANTS: Patients ≥ 18 years who underwent 1 of the 17 major orthopedic procedures, and with a length of stay (LOS) > 1 day. INTERVENTION: Patient Safety management between Italy and the USA. MAIN OUTCOME MEASURE: Patient Safety Indicators. RESULTS: A total of 14 393 patients in Italy (mean age = 59.8 years) and 131 371 in the USA (mean age = 65.4 years) were included. US patients had lower adjusted odds of developing a PSI compared to Italy for pressure ulcers (odds ratio [OR]: 0.21; 95% confidence interval [CI]: 0.10-0.45), hemorrhage or hematoma (OR: 0.42; CI 0.23-0.78), physiologic and metabolic derangement (OR: 0.08; CI 0.02-0.37). Italian patients had lower odds of pulmonary embolism/deep vein thrombosis (OR: 3.17; CI 2.16-4.67) compared to US patients. CONCLUSIONS: Important differences in patient safety events were identified across countries using US developed PSIs. Though caution about potential coding differences is wise when comparing PSIs internationally, other differences may explain AEs, and offer opportunities for cross-country learning about safe practices.
Authors: Teresa Bernadette Steinbichler; L Golm; D Dejaco; D Riedl; B Kofler; C Url; D Wolfram; H Riechelmann Journal: Eur Arch Otorhinolaryngol Date: 2020-01-25 Impact factor: 2.503
Authors: Lauren A Beaupre; Eugene K Wai; Donald R Hoover; Helaine Noveck; Darren M Roffey; Donald R Cook; Jay S Magaziner; Jeffrey L Carson Journal: Int J Qual Health Care Date: 2018-03-01 Impact factor: 2.038