Introdução à Medicina
2008/2009
Quality Indicators And
Healthcare
A First Step To The Evaluation Of A Hospital’s Performance
Authors
Ana Cristina Pereira
Ana Teresa Carapenha
Ana Rita Oliveira
André Vinha
Catarina Vieira
Eduardo Freitas
João Rebelo
Mariana Oliveira
Marli Cruz
Nuno Ribeiro
Victoriano Costa
Quality Of Healthcare
The indicators are the source of information to evaluate the performance
of a hospital.
KIRKMAN, Jamie John, BOUAMRA, Omar , 2008.
Introdução à Medicina - Turma 10
Quality Of Healthcare
Introdução à Medicina - Turma 10
Quality Of Healthcare
Values of the indicators as the basis to evaluate healthcare quality.
EDDY, David M., 1998
Introdução à Medicina - Turma 10
Research Question and Main Aim
How did quality and performance indicators evolve through the
years in a central hospital?
Our main objective is to calculate these indicators concerning
different variables and to have a perspective of the performance of
the hospital in case.
Definitive conclusions demand a more exaustive study.
Introdução à Medicina - Turma 10
Specific Aims
 Examination of healthcare quality.
 Definition of a hospital’s activity and production.
 Study of the quality of the data.
How will we do this?
Introdução à Medicina - Turma 10
Methods
Introdução à Medicina - Turma 10
Methods
SPSS (Statistical Package for the Social Sciences)
Provider of predictive analytics software and solutions. (*)
(*) SPSS: The Predictive Analytics Company: http://www.spss.com/corpinfo/?source=homepage&hpzone=nav_bar
Introdução à Medicina - Turma 10
Methods
DRGs
“A system for classifying patient care by relating common characteristics
such as diagnosis, treatment, and age to an expected consumption of
hospital resources and length of stay.” (*)
ICD-9-CM
“ICD-9-CM is the official system of assigning codes to diagnoses and
procedures associated with hospital utilization in the United States.” (**)
INE
“The entity responsible for ensuring the production and dissemination of
official statistical information.” (***)
(*)
MeSh definition
Classifications of Diseases and Functioning & Disability: http://www.cdc.gov/nchs/about/otheract/icd9/abticd9.htm
(***) Statistics Portugal: http://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_cont_inst&ine_smenu.boui=13918434&INST=53864&xlang=en
(**)
Introdução à Medicina - Turma 10
Methods
Introdução à Medicina - Turma 10
Expected Results
Evolution of Mortality from 2000 to 2005
5.0
4.5
Percentage of obits
4.0
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
2000
2001
2002
2003
2004
2005
Year
Introdução à Medicina - Turma 10
Expected Results
Percentage of obits by gender
44.4%
55.6%
Female
Male
Introdução à Medicina - Turma 10
Expected Results
Outpatient and normal episodes
2005
9.5%
90.5%
2004
11%
89.0%
2003
10.1%
89.9%
Year
Outpatient episodes
Normal episodes
2002
8.1%
91.9%
2001
7%
93.0%
2000
5%
95%
0%
20%
40%
60%
80%
100%
Introdução à Medicina - Turma 10
References
• EDDY, David M. ‘’Performance measurements: problems and solutions in Health Affairs. Vol.17. 4, 1998.
• REINHARDT,U: ‘’Quality in comsumer Driven Health Systems’’, International Journal for Health Care. 1998; 10(5)
• BENTES, Margarida; BERARDO, Ana; MATIAS, Alberto: XVII Congresso da União Europeia de Gestores Hospitalares; 1999.
• GARDNER, Karen L; SIBTHORPE, Beverly; LONGSTAFF, Duncan. National quality and performance system for Divisions of
General Practice: early reflections on a system under development. 2007
• Geraedts M, Schwartze D, Molzahn T. Hospital quality reports in Germany: patient and physician opinion of the reported
quality indicators. Germany: BMC Health Serv Res.; 2007 Sep 28; 7-157.
• BENTES, Margarida; GONÇALVES, Maria da Luz; TRANQUADA, Suzete; URBANO, João. A utilização dos GDH’s como
instrumento de financiamento hospitalar. Gestão Hospital, 33-42.
• BRIZ, Teodoro; DIAS, Carlos Matias; FREITAS, Mário. Indicadores de saúde: uma visão de Saúde Pública, com interesse em
Medicina Geral e Familiar. Revista Portuguesa Clínica Geral 2007;23:439-50
• RIBEIRO, Nuno. Administração pública. TOC. 2000/08
• URIEL, Zanon. Qualidade da assistência médico-hospitalar: conceito e avaliação de indicadores. 2000 Jul-Set RAS _ Vol. 2, Nº 8.
Available from: http://www.cqh.org.br/files/ARTIGORAS08.pdf
Introdução à Medicina - Turma 10
References
• National report on health sector performance indicators 2003 [Internet]. Canberra: . Australian Institute of Health and Welfare;
2004.
• DIMICK, Justin B., WELCH, H. Gilbert, BIRKMEYER, John D. Surgical Mortality as an Indicator of Hospital Quality: The Problem
With Small Sample Size. JAMA. 2004;292:847-851.
• Classifications of Diseases and Functioning & Disability: International Classification of Diseases, Ninth Revision, Clinical
Modification (ICD-9-CM). [Cited 2 Dec 2008] Available from: http://www.cdc.gov/nchs/about/otheract/icd9/abticd9.htm
• SPSS: The Predictive Analytics Company. [Cited 16 Dec 2008] Available from:
http://www.spss.com/corpinfo/?source=homepage&hpzone=nav_bar
• Statistics Portugal. [Cited 17 Dec 2008] Available from:
http://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_cont_inst&ine_smenu.boui=13918434&INST=53864&xlang=en