"Öppna jämförelser" ger inget säkert mått på infarktvårdens kvalitet. Epidemiologiska registret duger inte för att jämföra landsting
Engelsk titel: "Open comparisons" no reliable measures of the quality of care in myocardial infarction. The epidemiological registry is not sufficient for county comparisons
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Författare:
Ryttberg B
;
Nyström E
;
Stenberg A
;
Palm K
;
Näslund I
Email: britta.ryttberg@orebroll.se
Språk: Swe
Antal referenser: 4
Dokumenttyp:
Artikel
UI-nummer: 09081333
Sammanfattning
In three consecutive national surveys for 2006-8, based on hospital administrative databases and known as “Open Comparisons”, Örebro County Council had the highest 28-day mortality rate of all counties in Sweden for both male and female patients admitted to hospital care for acute myocardial infarction (AMI). The aim of this study was to analyze the reasons for this and, if possible, make suggestions for improvements. Hospital records for a random sample (n=393 of 1570) of patients with the diagnosis AMI, admitted for hospital care to any of the hospital clinics in Örebro County Council during 2005, were examined by experienced cardiologists. In 5 % of all cases the diagnosis was uncertain since it could not be verified based on the Riks-HIA criteria (Register of Information and Knowledge about Swedish Heart Intensive care Admissions). When excluding cases from the cardiac clinic, the diagnosis was incorrect in 10 % of the cases. Incorrect diagnoses were mostly found at non-cardiac and non-internal medicine clinics, where only half of all cases had a verified diagnosis. Survival rate was lower among patients older than 80 years, patients whose infarction was a secondary disease or diagnosis, patients admitted to a non-cardiac clinic, and patients with an incorrect AMI diagnosis.