PMID- 27272404
OWN - NLM
STAT- MEDLINE
DCOM- 20170614
LR  - 20220331
IS  - 1464-3677 (Electronic)
IS  - 1353-4505 (Linking)
VI  - 28
IP  - 4
DP  - 2016 Sep
TI  - Evaluating patient safety indicators in orthopedic surgery between Italy and the 
      USA.
PG  - 486-91
LID - 10.1093/intqhc/mzw053 [doi]
AB  - OBJECTIVE: To compare patient safety in major orthopedic procedures between an 
      orthopedic hospital in Italy, and 26 US hospitals of similar size. DESIGN: 
      Retrospective analysis of administrative data from hospital discharge records in 
      Italy and Florida, USA, 2011-13. Patient Safety Indicators (PSIs) developed by 
      the Agency for Healthcare Quality and Research were used to identify inpatient 
      adverse events (AEs). We examined the factors associated with the development of 
      each different PSI, taking into account known confounders, using logistic 
      regression. SETTING: One Italian orthopedic hospital and 26 hospitals in Florida 
      with >/= 1000 major orthopedic procedures per year. PARTICIPANTS: Patients >/= 18 
      years who underwent 1 of the 17 major orthopedic procedures, and with a length of 
      stay (LOS) > 1 day. INTERVENTION: Patient Safety management between Italy and the 
      USA. MAIN OUTCOME MEASURE: Patient Safety Indicators. RESULTS: A total of 14 393 
      patients in Italy (mean age = 59.8 years) and 131 371 in the USA (mean age = 65.4 
      years) were included. US patients had lower adjusted odds of developing a PSI 
      compared to Italy for pressure ulcers (odds ratio [OR]: 0.21; 95% confidence 
      interval [CI]: 0.10-0.45), hemorrhage or hematoma (OR: 0.42; CI 0.23-0.78), 
      physiologic and metabolic derangement (OR: 0.08; CI 0.02-0.37). Italian patients 
      had lower odds of pulmonary embolism/deep vein thrombosis (OR: 3.17; CI 
      2.16-4.67) compared to US patients. CONCLUSIONS: Important differences in patient 
      safety events were identified across countries using US developed PSIs. Though 
      caution about potential coding differences is wise when comparing PSIs 
      internationally, other differences may explain AEs, and offer opportunities for 
      cross-country learning about safe practices.
CI  - (c) The Author 2016. Published by Oxford University Press in association with the 
      International Society for Quality in Health Care. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - Tedesco, Dario
AU  - Tedesco D
AD  - Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - 
      University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy.
FAU - Hernandez-Boussard, Tina
AU  - Hernandez-Boussard T
AD  - Stanford University School of Medicine, Biomedical Informatics, 1070 Arastradero 
      #373, Stanford, CA 94305-5559, USA.
FAU - Carretta, Elisa
AU  - Carretta E
AD  - Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - 
      University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy.
FAU - Rucci, Paola
AU  - Rucci P
AD  - Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - 
      University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy.
FAU - Rolli, Maurizia
AU  - Rolli M
AD  - Rizzoli Orthopedic Institute, Via G.C. Pupilli, 1, 40136 Bologna, Italy.
FAU - Di Denia, Patrizio
AU  - Di Denia P
AD  - Rizzoli Orthopedic Institute, Via G.C. Pupilli, 1, 40136 Bologna, Italy.
FAU - McDonald, Kathryn
AU  - McDonald K
AD  - Center for Health Policy, Center for Primary Care and Outcomes Research, Stanford 
      University, 117 Encina Commons, Stanford, CA 94305-6019, USA.
FAU - Fantini, Maria Pia
AU  - Fantini MP
AD  - Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - 
      University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy.
LA  - eng
GR  - K01 HS018558/HS/AHRQ HHS/United States
PT  - Journal Article
DEP - 20160606
PL  - England
TA  - Int J Qual Health Care
JT  - International journal for quality in health care : journal of the International 
      Society for Quality in Health Care
JID - 9434628
SB  - IM
MH  - Adult
MH  - Aged
MH  - Databases, Factual
MH  - Female
MH  - Florida
MH  - Humans
MH  - Italy
MH  - Male
MH  - Middle Aged
MH  - *Orthopedics
MH  - Patient Safety/*standards
MH  - *Quality Indicators, Health Care
OTO - NOTNLM
OT  - adverse events
OT  - hospital care
OT  - pressure ulcers
OT  - quality indicators
OT  - safety indicators
OT  - surgery
EDAT- 2016/06/09 06:00
MHDA- 2017/06/15 06:00
CRDT- 2016/06/09 06:00
PHST- 2016/04/15 00:00 [accepted]
PHST- 2016/06/09 06:00 [entrez]
PHST- 2016/06/09 06:00 [pubmed]
PHST- 2017/06/15 06:00 [medline]
AID - mzw053 [pii]
AID - 10.1093/intqhc/mzw053 [doi]
PST - ppublish
SO  - Int J Qual Health Care. 2016 Sep;28(4):486-91. doi: 10.1093/intqhc/mzw053. Epub 
      2016 Jun 6.