Qualitätsvariation in der Schweiz: Analyse der
                    Mamma-Resektionen bei Brustkrebs anhand des Qualitätsindikators der
                    Brusterhaltung

Moser, Dominik; Ahlen, Christine von; Geißler, Alexander

doi:10.1055/a-1670-7249

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…A quality-oriented development has already been evident for several years in the area of healthcare planning, which is increasingly also based on quality criteria such as minimum volume regulations, certi cations, or the availability of specialised staff [4]. Apart from this, the quality initiatives to date are patchy and of limited informative value [5,6].…”

Section: Introductionmentioning

confidence: 99%

Inpatient Quality Indicators of General Internal Medicine: Implementation Study with Practicability Assessment and Retrospective Data Analysis

von Ahlen,

Moser,

Schneider

et al. 2024

Preprint

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BACKGROUND In the summer of 2021, the Swiss Society for General Internal Medicine (SGAIM) published six quality indicators for the inpatient sector for the first time. The aim of these indicators is to facilitate a structured quality improvement process in internal medicine. The present implementation study examines the practicability of the quality indicators recommended by the SGAIM. METHODS The QUALIFY assessment tool for quality indicators is used to assess the practicability of the SGAIM indicators in a structured manner based on their implementation in a single center. Within this framework, a retrospective data analysis of the years 2020 and 2021 was carried out. RESULTS The results were calculated according to the recommended evaluation intervals and were as such: A provisional discharge report within 24 hours was sent to the follow-up institution for an average of 23.7% of discharges. A new prescription of benzodiazepines in patients with an age of ≥ 65 years occurred in an average of 17.2% of patients per month. The fall history was collected from 100% of the patients. The monthly proportion of patients with transfusions with an Hb value of > 8g/dl was 17.9% on average. The proportion of CIRS cases per patient averaged 1.3%. Hepatitis B vaccination protection was available to 100%. CONCLUSIONS The quality indicators recommended by the SGAIM for the transmission of provisional discharge reports, new prescriptions for benzodiazepines and transfusions with Hb values > 8 g/dl provided added value in everyday clinical practice CIRS case processing, biography of falls in the last 12 months and hepatitis B vaccination protection did not provide any benefit for practice in their current form.

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Section: Introductionmentioning

confidence: 99%

Inpatient Quality Indicators of General Internal Medicine: Implementation Study with Practicability Assessment and Retrospective Data Analysis

von Ahlen,

Moser,

Schneider

et al. 2024

Preprint

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“…Apart from this, the quality initiatives to date are patchy and of limited informative value [4,5]. For example, the Federal O ce of Public Health (FOPH) has been publishing quality indicators for Swiss acute hospitals since 2008 (Swiss Inpatient Quality Indicators, CH-IQI) [6].…”

Section: Introductionmentioning

confidence: 99%

The Practicability of Swiss General Internal Medicine Quality Indicators in Hospital Inpatient Care

Ahlen

Moser

Schneider

et al. 2023

Preprint

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BACKGROUND: The quality transparency of medical care in Switzerland is underdeveloped in comparison to the range of healthcare services and utilisation of care. In order to strengthen the focus on quality, the Health Insurance Act (KVG) was revised and the Federal Quality Commission (EQK) was established. In the summer of 2021, the Swiss Society for General Internal Medicine (SGAIM) published six quality indicators for the inpatient sector, which support national efforts. The aim of these indicators is to facilitate a structured quality improvement process in internal medicine. There are currently no reference or comparative values for the SGAIM quality indicators. The present implementation study examines the practicability of the quality indicators recommended by the SGAIM in a hospital. It examines which quality indicators are helpful and supports the quality improvement cycle intended by the SGAIM. METHODS: Using the QUALIFY assessment tool for quality indicators, the SGAIM indicators are structurally evaluated using the example of Hospital Männedorf (Canton of Zurich). Within this framework, a retrospective data analysis of the years 2020 and 2021 was carried out with 5,376 internal medicine patients, internal medicine assistants and management physicians (32 in 2020; 34 in 2021) as well as the CIRS reporting circle of internal medicine. RESULTS: The examination of the methodological quality criteria for practicability according to the QUALIFY assessment instrument showed that many of the methodological quality criteria are fulfilled. However, the comprehensibility and interpretability for patients and the public are only given to a limited extent. The results of the SGAIM quality indicators in Hospital Männedorf were calculated according to the recommended evaluation intervals and were as such: A provisional discharge report within 24 hours was sent to the follow-up institution for an average of 23.7% of discharges. A new prescription of benzodiazepines in patients with an age of ≥65 years occurred in an average of 17.2% of patients per month. The fall history was collected from 100% of the patients. The monthly proportion of patients with transfusions with an Hb value of >8g/dl was 17.9% on average. The proportion of CIRS cases per patient averaged 1.3%. Hepatitis B vaccination protection was available to 100% of the staff in the medical service of internal medicine. Reference and comparative values for the classification of these results do not yet exist. CONCLUSIONS: The quality indicators recommended by the SGAIM for the transmission of provisional discharge reports, new prescriptions for benzodiazepines and transfusions with Hb values >8 g/dl proved helpful. Development potential was shown for the following quality indicators: CIRS case processing, biography of falls in the last 12 months and hepatitis B vaccination protection. In the sense of national quality development in accordance with the KVG, it is desirable that the specialist society further develops its quality indicators and contributes them to the national quality efforts, which are coordinated by the EQK.

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“…Due to the information asymmetry between patients and providers, quality data, the public and critical discussion about them, and benchmarks make an important contribution to quality transparency [17]. In the future, this will allow the increased inclusion of outcome quality for health care planning to enable the balanced consideration of all three factors (effective, appropriate, economic) and to reduce quality variation [18]. Therefore, in the present study, we would like to contribute to quality transparency by including the following quality indicators: Unplanned readmissions within 30 days of discharge and treatments planned for outpatients who ultimately unexpectedly required stationary care anyway.…”

Section: Introductionmentioning

confidence: 99%

Cost and Quality Comparison of Hernia Surgery in Stationary, Day-Patient and Outpatient Care

Enodien

Moser²,

Kessler³

et al. 2022

IJERPH

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Background: Medical progress is increasingly enabling more and more stationary treatment to be provided in the outpatient sector. This development should be welcomed, as healthcare costs have been rising for years. The design of efficient processes and a needs-based infrastructure enable further savings. According to international recommendations (EHS/IEHS), outpatient treatment of unilateral inguinal hernias is recommended. Method: Data from patients in GZO Hospital between 2019 and 2021 for unilateral inguinal hernia repair was included in this study (n = 234). Any over- or under-coverage correlated with one of the three treatment groups: stationary, partially stationary and patients treated in outpatients clinic. Complications and 30-day readmissions were also monitored. Results: Final revenue for all patients is −95.36 CHF. For stationary treatments, the mean shifts down to −575.01 CHF, for partially stationary treatments the mean shifts up to −24.73 CHF, and for patients in outpatient clinic final revenue is 793.12 CHF. This result is also consistent with the operation times, which are lowest in the outpatient clinic with a mean of 36 min, significantly longer in the partially stationary setting with 58 min, and longest in the stationary setting with 76 min. The same applies to the anesthesia times and the relevant care times by the nurses as the most important cost factors in addition to the supply and allocation costs. Conclusions: We show that cost-effective elective unilateral inguinal hernia care in the outpatient clinic with profit (mean 793.12 CHF) is possible. Stationary unilateral hernia care (mean −575.01 CHF) is loss-making. Crucial factors for cost efficiency are optimized processes in the operating room (anesthesia, surgical technique and quality, operating time), as well as optimized care processes with minimal preoperative services and care times for the patient. However, at the same time, these optimizations pose a challenge to surgical and anesthesiology training and structures with high levels of preoperative and Postoperative services and pay-as-you-go costs. The complication rate is 0.91% lower than in a comparable study. The readmission within 30 days post-operation results with a positive deviation of −3.53% (stationary) and with a negative deviation of +2.29% (outpatient clinic) compared to a comparative study.

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Qualitätsvariation in der Schweiz: Analyse der Mamma-Resektionen bei Brustkrebs anhand des Qualitätsindikators der Brusterhaltung

Cited by 4 publications

References 12 publications

Inpatient Quality Indicators of General Internal Medicine: Implementation Study with Practicability Assessment and Retrospective Data Analysis

Inpatient Quality Indicators of General Internal Medicine: Implementation Study with Practicability Assessment and Retrospective Data Analysis

The Practicability of Swiss General Internal Medicine Quality Indicators in Hospital Inpatient Care

Cost and Quality Comparison of Hernia Surgery in Stationary, Day-Patient and Outpatient Care

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