Centre for Health and Social Economics CHESS, National Institute for Health and Welfare, Helsinki, Finland.
Health Policy. 2012 Feb;104(2):155-62. doi: 10.1016/j.healthpol.2011.08.012. Epub 2011 Sep 28.
To examine the association between patient injury claims and well-known quality indicators and to assess whether claims can be utilised in performance measurement.
Data were derived from administrative registers and comprised hip and knee replacement patients (n=34181) in Finland from 1998 to 2003. Hospital-level correlations were calculated between claims and quality indicators (5-year revision rate, 1-year deep infection rate, and 14-day readmission rate), while logistic regression analysis was used to analyze patient-level data for an association between claims and quality indicators.
Correlations between claims and revisions as well as claims and infections were statistically significant, with correlation coefficients ranging from 0.21 to 0.62. In the regression analysis, both the revision and the infection indicator had a positive and statistically significant association with filing a claim (OR 1.002; 95% CI 1.001-1.003 and 1.001; 1.00005-1.001, respectively) and obtaining compensation (1.003; 1.001-1.005 and 1.001; 1.0003-1.002, respectively).
A claims indicator has the potential to be applied as a quality indicator. It should be complemented, however, with other indicators or actions to improve its acceptability by health professionals and to mitigate its possible undesirable effects.
研究患者伤害索赔与知名质量指标之间的关联性，并评估索赔是否可用于绩效评估。
数据来源于芬兰 1998 年至 2003 年间的髋关节和膝关节置换患者的行政登记册（n=34181）。计算了医院层面索赔与质量指标（5 年修订率、1 年深部感染率和 14 天再入院率）之间的相关性，同时使用逻辑回归分析患者层面数据，以分析索赔与质量指标之间的关联。
索赔与修订以及索赔与感染之间的相关性具有统计学意义，相关系数范围为 0.21 至 0.62。在回归分析中，修订和感染指标均与提出索赔（OR 1.002；95%CI 1.001-1.003 和 1.001；1.00005-1.001）和获得赔偿（1.003；1.001-1.005 和 1.001；1.0003-1.002）具有正相关且具有统计学意义。
索赔指标具有作为质量指标的应用潜力。然而，它应辅以其他指标或行动，以提高其被卫生专业人员接受的程度，并减轻其可能产生的不良影响。
