Are medical record front page data suitable for risk adjustment in hospital performance measurement? Development and validation of a risk model of in-hospital mortality after acute myocardial infarction

ObjectivesTo develop a model of in-hospital mortality using medical record front page (MRFP) data and assess its validity in case-mix standardisation by comparison with a model developed using the complete medical record data.DesignA nationally representative retrospective study.SettingRepresentative hospitals in China, covering 161 hospitals in modelling cohort and 156 hospitals in validation cohort.ParticipantsRepresentative patients admitted for acute myocardial infarction. 8370 patients in modelling cohort and 9704 patients in validation cohort.Primary outcome measuresIn-hospital mortality, which was defined explicitly as death that occurred during hospitalisation, and the hospital-level risk standardised mortality rate (RSMR).ResultsA total of 14 variables were included in the model predicting in-hospital mortality based on MRFP data, with the area under receiver operating characteristic curve of 0.78 among modelling cohort and 0.79 among validation cohort. The median of absolute difference between the hospital RSMR predicted by hierarchical generalised linear models established based on MRFP data and complete medical record data, which was built as ‘reference model’, was 0.08% (10th and 90th percentiles: −1.8% and 1.6%). In the regression model comparing the RSMR between two models, the slope and intercept of the regression equation is 0.90 and 0.007 in modelling cohort, while 0.85 and 0.010 in validation cohort, which indicated that the evaluation capability from two models were very similar.ConclusionsThe models based on MRFP data showed good discrimination and calibration capability, as well as similar risk prediction effect in comparison with the model based on complete medical record data, which proved that MRFP data could be suitable for risk adjustment in hospital performance measurement.

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Evaluasi Ketepatan Antibiotik pada Pasien Sepsis

Pharmacon Jurnal Farmasi Indonesia ◽

10.23917/pharmacon.v18i2.16635 ◽

2021 ◽

Vol 18 (2) ◽

pp. 194-207

Author(s):

Ambar Yunita Nugraheni ◽

Mahyastuty Shintya Putri ◽

Adi Yusron Saputro

Keyword(s):

Medical Record ◽

Observational Data ◽

Inclusion Criteria ◽

Medical Record Data ◽

Exclusion Criteria ◽

Central Java ◽

Intravenous Antibiotics ◽

Record Data ◽

The Right ◽

Complete Medical Record

The administration of early intravenous antibiotics was one of the fundamental procedures in sepsis. Inappropriate of antibiotics in septic patients has an impact on mortality and prolongs treatment. The purpose of this study was to evaluate the appropriateness of antibiotics therapy in hospitalized sepsis patients in Central Java based on the parameters right indication, right patient, right drug, and the right dose. This study was observational. Data collected retrospectively and analyzed descriptively. Sampling was done by purposive sampling. The inclusion criteria were inpatients diagnosed with sepsis who received antibiotics therapy with complete medical record data. The exclusion criteria were patients who died of sepsis. Antibiotics analyzed using the DIH 25th edition 2016, IONI 2014, Tata Laksana Sepsis Pada Anak IDAI 2016, Neofax 2014, Kepmenkes PNPK Tata Laksana Sepsis 2017, PPK RS, and SHC Antimicrobial Dosing 2017. Based on data from 108 patients who fulfilled the inclusion criteria obtained results right indication 100%, right patient 97.22%, right drug 90.74%, and the right dose 48.15%. The most used antibiotic was a combination of ampicillin and gentamicin (41.67%), while the single antibiotic was ceftriaxone (12.96%).

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Comparison of risk adjustment methods in patients with liver disease using electronic medical record data

BMC Gastroenterology ◽

10.1186/s12876-016-0559-4 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 10

Author(s):

Yuan Xu ◽

Ning Li ◽

Mingshan Lu ◽

Elijah Dixon ◽

Robert P. Myers ◽

...

Keyword(s):

Liver Disease ◽

Medical Record ◽

Electronic Medical Record ◽

Risk Adjustment ◽

Medical Record Data ◽

Electronic Medical Record Data ◽

Record Data

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Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2004.04.005 ◽

2004 ◽

Vol 57 (10) ◽

pp. 1096-1103 ◽

Cited By ~ 713

Author(s):

Yuji Okura ◽

Lynn H. Urban ◽

Douglas W. Mahoney ◽

Steven J. Jacobsen ◽

Richard J. Rodeheffer

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Medical Record ◽

Self Report ◽

Medical Record Data ◽

Record Data

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Influential Factors in The Law Enforcement Process of Sexual Violence Cases in Children in The City of Semarang

SOEPRA ◽

10.24167/shk.v6i2.2912 ◽

2020 ◽

Vol 6 (2) ◽

pp. 4

Author(s):

Liya Suwarni

Keyword(s):

Law Enforcement ◽

Sexual Violence ◽

Medical Record ◽

Child Protection ◽

Influential Factors ◽

Medical Record Data ◽

Violence Against Children ◽

Record Data ◽

The Law ◽

The City

Background. Cases of sexual violence increase every year, victims ranging from adolescents, children to toddlers. Based on data from the Indonesian Child Protection Commission, abuse and violence against children in Indonesia in 2013 were 23 cases, in 2014 there were 53 cases, in 2015 there were 133 cases, 2017 reached 1,337 cases, and as of July 2018 there were 424 cases. Purpose. Knowing the factors that influence the law enforcement process of sexy violence cases in Semarang City. Method This study uses descriptive analytical methods for cases of violence against children, based on medical record data in hospitals, documents in Mapolrestabes, the District Attorney's Office and the Semarang City Court for the period of January 2015 to December 2018. Results. Based on research results obtained 213 experimental cases section from medical record data in hospitals in the city of Semarang. Most cases of child abuse occurred in 2018 with 72 cases. Most victims are 12-14 years old age group, female. Most types of cases are cases of intercourse. The majority of violations are persons known as victims, perpetrators not working, and most of the places of occurrence are in the defendant's house. At the time of prosecution and trial, the number of cases was significantly reduced to only 8 cases. Factors related to this include lack of evidence, difficulty in obtaining information from victims, convoluted statements of coverage, lack of election, and obtaining diversion rates. Conclusion Cases of sexual violence have increased from year to year. The process of law enforcement on this problem still has many difficulties in each manufacturing process which is still difficult to overcome.

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