Abstract
Can we accept the statistics provided by the Ministry of Health, which uses large computerized databases? Through MEDECHO, the Ministry provides to hospital managers, reports cards on different interventions. These reports compare different hospitals performances. Surgeons involved in the process hesitate to accept this information. Using the results of the performance of cholecystectomy provided by this system (Gr: A), we compared the same cohort (1 April-31 December 1996 = 346 cholecystectomies) but using specific criteria determined as relevant to our surgeons (Gr: B). The rate of complication gives a crude aftermath and no attempt was used to adjust for severity. The MEDECHO data are adjusted for severity. The global rate of complications is similar Gr: A 11%, Gr: B 12%. Major complication rate for pulmonary embolism, hemorrhage and biliary duct trauma are identical. The rate of surgical site infection is higher in Gr: B (5% vs. 2%). The patients are seen in the outpatient clinic and these observations are not included by the analytical system unless the patient has been readmitted. For our hospital, the MEDECHO data are valid and reliable even though they underestimated the wound infection rate. These results could be explained by an appropriate interpretation of the code system by the archivist and by the surgeons' precision to complete the summary sheet of hospitalization. We can conclude that these data can be used as a means to evaluate the quality of outcome of a surgical service.
Translated title of the contribution | Could we trust clinical statistics from data banks of the National Health Service (NHS)? |
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Original language | French |
Pages (from-to) | 11-13 |
Number of pages | 3 |
Journal | Annales de Chirurgie |
Volume | 129 |
Issue number | 1 |
DOIs | |
State | Published - Feb 2004 |
Externally published | Yes |
Keywords
- Banque de données informatisée
- Cholecystectomy
- Cholécystectomie
- Hospital performance
- Indicateurs de performance hospitalière
- Outcome indicators
- Quality assessment
- Report cards
- Évaluation de la qualité
ASJC Scopus subject areas
- Surgery