Faculty Opinions recommendation of Pediatric testicular torsion epidemiology using a national database: incidence, risk of orchiectomy and possible measures toward improving the quality of care.

2011 ◽  
Author(s):  
Michael Ost ◽  
Janelle Fox
Keyword(s):  
Quality Of Care ◽  
Testicular Torsion ◽  
National Database ◽  
Incidence Risk

scholarly journals Prevalence of amputations amongst people with type 2 diabetes enrolled in primary care in England

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B Meza-Torres ◽  
C Heiss ◽  
S Cunningham ◽  
F Carinci ◽  
S de Lusignan
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Quality Of Care ◽  
General Practitioners ◽  
Distinct Pattern ◽  
National Database ◽  
Cross Sectional ◽  
Clinical Records

Abstract Background Different patterns of co-morbidities observed among people with type 2 diabetes (T2D) and lower extremity amputations (LEA) compared with those without may provide insights into the quality of care provided by general practitioners in England. We analysed routinely recorded clinical data to build predictive models for benchmarking and continuous improvement. Methods A cross-sectional computerized data extraction of clinical records from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) database of people with T2D in England. Key target cases were defined as adults with T2D and a record of major/minor LEA between 2008-2019 vs all subjects with T2D without amputation. Quality of care was assessed in terms of percentage of patients treated with optimal medical therapy and diagnostic procedures and referred to specialized care according to their clinical profile. The association between quality of care and outcomes was explored using a logistic regression model, adjusting for case-mix. Results During the last decade, in a sample covering approximately 7.4% of all general practitioners in England, a total of 1,052 subjects out of 127,100 adults with T2D had a LEA (832 per 100,000). The median time since amputation was 3.4 years. Only 410 (38%) patients had a recorded DFU diagnosis prior to the amputation, with a median of 2 years from diagnosis to amputation. Major LEA was recorded in 280 (27%) cases. People with a record of retinopathy, peripheral arterial disease, renal disease, neuropathy and DFU had a higher risk of amputations. Quality of care was heterogeneous between patients with and without LEA. Conclusions People with T2D and LEA have a distinct pattern of co-morbidities some of which may be sensitive to improved primary care management, and differential quality of care. Models built using this national database can routinely monitor amputations in England. Variation in treatment should be properly investigated. Key messages The automated extraction of clinical cases from a national database may help shed light on clinical patterns among people with diabetes at high risk of amputations, based on evidence-based criteria. Variation in treatment and quality of care among amputated vs non-amputated subjects can be rapidly explored using a cross-sectional analysis of current records.

Immunization Performance Measurement in a Changing Immunization Environment

PEDIATRICS ◽  
1999 ◽  
Vol 103 (Supplement_1) ◽  
pp. 889-897 ◽  
Author(s):  
Lance Rodewald ◽  
Edmond Maes ◽  
John Stevenson ◽  
Bridget Lyons ◽  
Shannon Stokley ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Performance Measurement ◽  
Immunization Coverage ◽  
Primary Care Providers ◽  
National Database ◽  
Care Providers ◽  
Immunization Status ◽  
Technical Issues

Objective. The measurement of performance in the delivery of recommended vaccinations for children is used frequently as a marker for quality of care and as an outcome for studies of interventions to improve immunization coverage levels. The critical element of immunization performance measurement is the determination of immunization status. This methodologic review 1) discusses immunization status as a measure of quality of primary care for children, 2) describes immunization status measures used in immunization intervention studies, and 3) examines selected technical issues of immunization status measurement. Methods and Topics. 1) Description of the characteristics of immunization status measurements obtained by a systematic review of studies published between 1980 and 1997 on interventions to raise immunization coverage, and 2) illustration of technical considerations for immunization status measurement using one local database and one national database of immunization histories. Technical issues for immunization status measurement include 1) the need to use documented immunization histories rather than parental recall to determine immunization status, 2) the need to link records across providers to obtain complete records, 3) the sensitivity of immunization status to missing immunization data, and 4) the potential of measures incorporating combinations of immunizations to underestimate the degree of vaccination in a population. Conclusions. Immunization performance measurement has many characteristics of a robust quality of care measure, including high acceptance by primary care providers of routine vaccination, association of immunization status with the conduct of other clinical preventive services, agreed-on technical and programmatic standards of care, and legislative requirements for medical record documentation. However, it is not without challenges. Careful attention to technical issues has potential to improve immunization delivery health services research.

scholarly journals Quality of Care for Children with Malaria at Private Health Facilities in Mid-Western Region of Uganda: A Cross Section Study

2020 ◽  
Author(s):  
Humphrey Wanzira ◽  
Daniel Tumwine ◽  
Patrick Bukoma ◽  
Allan Musiime ◽  
Juliet Biculu ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Case Management ◽  
Malaria Case ◽  
Malaria Treatment ◽  
Health Facilities ◽  
National Database ◽  
Western Region ◽  
Malaria Case Management

Abstract Background Approximately 50 percent of the population in Uganda seeks health care from private facilities but there is limited data on the quality of care for malaria in these facilities. This study aimed to document the quality of malaria case management in private health facilities in nine districts in the Mid-Western region of Uganda, an area of moderate malaria transmission.Methods This was a cross sectional study in which purposive sampling was used to select fifteen private-for-profit facilities from each district. An interviewer-administered questionnaire that contained both quantitative and open-ended questions was used. Information was collected on availability of treatment aides, knowledge on malaria, malaria case management, laboratory practices, malaria drugs stock and data management. We determined the proportion of health workers that adequately provided malaria case management according to national standards.Results Of the 135 health facilities staff interviewed, 61.48% (52.91 - 69.40) had access to malaria treatment protocols while 48.89% (40.19 - 57.63) received malaria training. The majority of facilities, 98.52% (94.75 - 99.82) had malaria diagnostic services and the most commonly available anti-malarial drug was artemether-lumefantrine, 85.19% (78 - 91), followed by Quinine, 74.81% (67 - 82) and intravenous artesunate, 72.59% (64 – 80). Only 14.07% (8.69 – 21.10) responded adequately to the acceptable cascade of malaria case management practice. Specifically, 33.33% (25.46 - 41.96) responded correctly to management of a patient with a fever, 40.00% (31.67 - 48.79) responded correctly to the first line treatment for uncomplicated malaria, whereas 85.19% (78.05 - 90.71) responded correctly to severe malaria treatment. Only 28.83% submitted monthly reports, where malaria data was recorded, to the national database.Conclusion This study revealed sub-optimal malaria case management practices at private health facilities with approximately 14% of health care workers demonstrating correct malaria case management cascade practices. This was due to limited access to malaria case management protocols and guidelines, lack of adequate staff training and supportive supervision, stock-outs of essential anti-malarial commodities and inadequate malaria related community level sensitization. The national malaria control programme could consider this information to inform specific areas of focus for strengthening malaria case management in the private health facilities.

Evaluations of effectiveness and quality of care

1989 ◽  
Vol 53 (11) ◽  
pp. 673-676 ◽  
Author(s):  
JJ Crall
Keyword(s):  
Quality Of Care

Quality of Care

ASHA Leader ◽  
2012 ◽  
Vol 17 (6) ◽  
pp. 2-2
Author(s):  
Dennis Hampton
Keyword(s):  
Quality Of Care

V708: Partial Nephrectomy for Small Renal Masses: An Emerging Quality of Care Concern?

2006 ◽  
Vol 175 (4S) ◽  
pp. 229-229
Author(s):  
David C. Miller ◽  
John M. Hollingsworth ◽  
Khaled S. Hafez ◽  
Stephanie Daignault ◽  
Brent K. Hollenbeck
Keyword(s):  
Quality Of Care ◽  
Partial Nephrectomy ◽  
Small Renal Masses ◽  
Renal Masses
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