Preliminary Report of Data Collection in Hospital Quality Assurance Programs—a Project of the Association of Hospitals of the Czech Republic

Objectives: This was the first attempt of the association representing all acute care hospitals in the Czech Republic to collect mutual data which might be used for quality assurance (QA) purposes and which might lead to the development of national standards of care which could be used for hospital...

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Bibliographic Details
Published in:International journal for quality in health care 1996-12, Vol.8 (6), p.577-582
Main Authors: FARMER, RICHARD G., MARX, DAVID, ROITHOVA, ZUZANA
Format: Article
Language:English
Subjects:
Accreditation
Bed Occupancy
Czech Republic
Data Collection - methods
Health Services Research
Hospital Administration - standards
Hospital Mortality
Humans
Length of Stay
Medical Staff, Hospital - supply & distribution
Pilot Projects
Quality Assurance, Health Care - organization & administration
Societies, Hospital
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Summary:Objectives: This was the first attempt of the association representing all acute care hospitals in the Czech Republic to collect mutual data which might be used for quality assurance (QA) purposes and which might lead to the development of national standards of care which could be used for hospital accreditation. Data collected included information which was available universally and which could be measured; in addition, information was intended to be similar in each hospital. In most cases, the data collection systems were based on financial information and data had to be identified which might be used for QA purposes, rather than being able to design a system specific for QA purposes. Design: Since the hospital payment system was established in 1992, hospitals have had to develop data collection systems to measure clinical activity; this current study was based on this data collection, adapted to QA purposes. Setting: The Executive Committee of the Hospital Association agreed to a pilot study of hospitals in 1993; data were collected from approximately 40 hospitals, beginning in 1994. Study participants: Hospitals were chosen based on their ability to collect data and participate in the program, and it was determined that there should be variability in the hospitals, in size, location and activities, but that the data collected should be generic. Interventions: Raw data included 33 different items, most of which were irrelevant to QA. Using a computer program, various combinations of data were reviewed and evaluated to ascertain the most appropriate for QA purposes. Main outcome measures: Data were chosen for study which included (a) data from the largest departments in the individual hospitals; (b) length of stay for patients hospitalized in these departments; (c) number of occupied beds/physician in the department and (d) mortality/1000 admissions to the department. Results: The combination of (1) a long length of stay; (2) a high occupied bed/doctor ratio; and (3) a high mortality rate/1000 admissions might be indicators of poor quality. Additional factors to consider include: the type of department — emergency, cancer, geriatric, etc.; the nature of the medical activity — acute, referral, primary care, etc.; whether or not “social” beds are included and, generally, comparability among departments. However, as a pilot study, certain indicators can be determined which then can be used for future study to determine quality of care. The ability to cooper
ISSN:1353-4505
1464-3677
DOI:10.1093/intqhc/8.6.577