Abstract:The clinical content of administrative databases includes, among others, patient demographic characteristics, and codes for diagnoses and procedures. The data in these databases is standardized, clearly defined, readily available, less expensive than collected by other means, and normally covers hospitalizations in entire geographic areas. Although with some limitations, this data is often used to evaluate the quality of healthcare. Under these circumstances, the quality of the data, for instance, errors, or it completeness, is of central importance and should never be ignored. Both the minimization of data quality problems and a deep knowledge about this data (e.g., how to select a patient group) are important for users in order to trust and to correctly interpret results. In this paper we present, discuss and give some recommendations for some problems found in these administrative databases. We also present a simple tool that can be used to screen the quality of data through the use of domain specific data quality indicators. These indicators can significantly contribute to better data, to give steps towards a continuous increase of data quality and, certainly, to better informed decision-making.
Este estudo teve como objectivos principais identificar constructos neurocognitivos que se apresentam de modo diferencial como preditores de dimensões específicas do funcionamento psicossocial de pessoas com Esquizofrenia, e analisar o contributo adicional da auto-eficácia geral como possível variável preditora. Para tal, constituímos uma amostra composta por 37 pessoas com Esquizofrenia, que avaliamos com uma bateria de testes neurocognitivos e com instrumentos de funcionamento psicossocial e de autoeficácia. Recorremos a análises de regressão para a obtenção dos modelos preditores, com recurso aos métodos stepwise e enter. Os modelos preditores iniciais explicaram entre 17% e 67% da variância nas diferentes dimensões do funcionamento psicossocial. Os preditores neurocognitivos significativos foram a memória de trabalho, a atenção, a velocidade de processamento, o raciocínio lógico e a memória visuoespacial. Não encontramos qualquer preditor significativo dos comportamentos de Não-perturbação. Nos modelos realizados com a auto-eficácia, verificamos que esta se constituiu como preditor significativo da dimensão Auto-cuidado e Contacto social. Estes resultados sugerem que a promoção do funcionamento psicossocial (com excepção dos comportamentos violentos ou de perturbação) poderá passar pela intervenção sistemática ao nível do desenvolvimento de competências cognitivas e de percepções mais positivas de eficácia pessoal.
Introduction: Hospitals are complex organizations and the quality and efficiency of care and the hospital assessment performance are complex features to measure and estimate. Aim: To extract an useful knowledge from hospital databases to develop a hospital dashboard for quality and management indicators and to generate sufficient information, relevant and timely, to assist in decisionmaking processes. Methods: This study was structured with four distinct phases: preliminary study, literature review, definition and development, and evaluation results. Results: The preliminary studies were grouped in production and quality hospital indicators. In 2010 there was a reduction (3.5%) in the total number of episodes, a reduction (30%) on exceptional short LOS episodes, a significant reduction of obstetric complications, and an increase the problems related to clinical coding. Discussion: In a preliminary way, it can be observed the importance in a hospital management of such results synthesized and summarized in groups of production and quality hospital indicators. Conclusion: This work comprises the study of solutions can contribute to the improvement of healthcare delivery, aiming towards management support and the desired hospital operating costs reduction.
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