Quality Indicators
Conditions
Brief summary
The aim of the study is to identify and evaluate incentive mechanisms for the implementation of quality-relevant care processes. The objective is to correlate adherence to individual process-based quality indicators or their combination with outcome data. In addition, cost shares and case revenues are evaluated. Indices are also derived from routine data that may represent additional influencing factors (Charlson Comorbidity Index or secondary diagnoses that increase case severity based on ICD-10 coding and procedures based on the Surgery and procedure codes system).
Detailed description
Within the Department of Anesthesiology and Intensive Care Medicine CCM/CVK at Charité- University Medicine Berlin, the systematic evaluation of quality-related process indicators is standard practice. These are based on the intensive care quality indicators of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI). These process-based indicators are to be correlated with the examination of outcome indicators from routine data transmission in accordance with §21 data record (e.g., 30-day readmission rate, mortality, infection rate, length of stay) and economic parameters of treatment from controlling data (Diagnosis Related Groups revenue, case costs). The §21 data record describes a standardized data format that hospitals are required to transmit to the Institute for the Hospital Remuneration System (InEK) in accordance with § 21 (4) and (5) Act on Fees for Full and Partial Inpatient Hospital Services (Hospital Fees Act - KHEntgG). Data on standard clinical care from the Charité hospital systems will be used.
Interventions
None listed
Sponsors
Charite University, Berlin, Germany
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with complete, electronically documented intensive care treatment data, including vital sign monitor data and laboratory data from the patient documentation system. * Complete, electronically documented treatment data for these patients from the hospital information system. * Data from cost and revenue accounting from the hospital information system, §21 routine data records. * Age ≥ 18 years * Length of stay \> 24 hours * Intensive care units from the Department of Anesthesiology and Intensive Care Medicie (CCM/CVK) of Charité - University Medicine Berlin: "M101I", 'MPACU', "WAN-S14I", "WAN-S8I", "WAN-PACU". Since the introduction of electronic patient records, some of these intensive care units have had different names (e.g., MAN-101i, MAN-103i, W1i).
Exclusion criteria
-none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proceeds | 2012-2023 | Per Case Revenue in Euro \[€\] (Revenue = base rate x DRG-rate) according to the Diagnosis Related Groups (DRG) reimbursement flat rate catalogue and the base rate for the state of Berlin for the respective billing year. |
| Case costs | 2012-2023 | Per case costs in Euro \[€\] according to case-related analysis based on financial controlling data. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Charlson Comorbidity Index | 2012-2023 | Charlson Comorbidity Indices are generated from the number and type of secondary diagnoses according to ICD-10 Diagnosis Related Groups coding.(Scale from 0-37; higher Score values indicating more severe comorbidities and less probability of 10-year survival) |
| 30-day readmission rate | 2012-2023 | 30-day readmission rate from routine data up to one year |
| In-house mortality | 2012-2023 | In-house mortality from routine data up to one year |
| Infection rate | 2012-2023 | Infection rate form routine data, based on ICD-10 coding |
| Length of hospital stay (days) | 2012-2023 | Length of hospital stay from routine data |
| Length of intensive care unit stay (hours and days) | 2012-2023 | Length of intensive care unit stay from routine data |
| Patient Related Outcome Measures (PROM) | 2012-2023 | Patient Related Outcome Measures (PROM) are collected from routine data of patients with Post Intensive Care Syndrome. Presence of PICS is based on ICD-10 codes and specific combinations. |
| Measures of circadian rhythms | 2012-2023 | Measures of circadian rhythms are determined using biometric routine data. |
Countries
Germany
Contacts
CONTACTClaudia Spies, MD, Prof.
PRINCIPAL_INVESTIGATORClaudia Spies, MD, Prof.
Charite University, Berlin, Germany
Outcome results
None listed