Benchmarking in Critical Care

International comparison of the performance of the paediatric index of mortality (PIM) 2 score in two national data sets

“…The case mix was different between these two countries. Finally, in the FS data set only the voluntary PICUs were included, whereas Glance [39] has proposed that all ICUs participate in a national ICU-outcome database as was the case for the GB data set. Such differences have previously been observed: crude mortality in PICUs was lower in Australia (4.1%) than in the UK (8.2 %) [9], whereas the infant mortality rate (4.4/1,000 versus 4.7/ 1,000 respectively) is about the same in these two countries [35].…”

“…Infant mortality rate is lower in France than in the UK (3.6/1,000 versus 4.7/1,000) [35], but in the present study, crude mortality was higher in the FS database. Universal participation would eliminate the possibility of selection bias, in contrast to voluntary participation that may result in a nonrepresentative group of ICUs [39]. In the study by Brady et al optimized models were assessed by random allocation of PICUs (stratified by annual admission number) into development and validation samples in a 2:1 ratio [10].…”

The significance of risk adjustment for the assessment of results in intensive care. : An analysis of risk adjustment models used in Swedish intensive care.

“…There appears to be consensus that time-fixed (for example 30-day) mortality is a less biased measure than in-hospital mortality, and timefixed mortality endpoints are being demanded more and more [27][28][29]. Time-fixed mortality is not affected by discharge to another hospital or short length of hospital stay.…”

“…There is thus good reason to investigate outcome endpoints that are fixed over time, for example 30, 90 or 180 days after ICU admission, as they are less affected by administrative factors such as hospitalisation [29].…”

Prognostic performance of the Simplified Acute Physiology Score II in major Croatian hospitals: a prospective multicenter study

“…Benchmarking has been recently included among indicators for improving the safety and quality of care for intensive care patients (30). In this sense, it is necessary to create a national database of intensive care outcomes, compare the existing ICUs, find ICUs of excellent practice, and spread it all over the country (31). …”