...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>British Journal of Obstetrics and Gynaecology >The standard primipara as a basis for inter-unit comparisons of maternity care.
【24h】

The standard primipara as a basis for inter-unit comparisons of maternity care.

机译：标准的产妇作为产妇保健单位间比较的基础。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: To assess the suitability of the standard primipara (a subset of the obstetric population that has relatively low risk or intervention and of adverse outcome) for making inter-unit comparisons of indicators of the process and outcome of maternity care. DESIGN: Inter-unit comparison of 10 indicators of obstetric intervention and adverse outcome derived from routinely collected computerised data held on the St Mary's Maternity Information System. SETTING: Fifteen maternity units in the former North West Thames Region. PARTICIPANTS: 15,463 primiparae who were delivered in 1992. MAIN OUTCOME MEASURES: Proportion of primiparae within the standard definition; degree to which standard primiparae are associated with lower rates of intervention and adverse outcome, as compared to other primiparae. RESULTS: Within the database, 42.6% of all primiparae were found to be standard, with rates varying between units from 25.9% to 57.7%. As expected, the standard primiparous woman is at less risk of intervention or adverse outcome than other primiparae. All but one component variable of the standard definition is a significant risk factor for at least four of the 10 indicators. Statistically significant differences in indicator rates are seen between standard and nonstandard primiparae within units. Within the standard group, significant differences in rates of intervention and adverse outcome are seen between units. Units with relatively high levels of intervention within the higher risk nonstandard group also have relatively high levels of intervention within the standard group. CONCLUSIONS: Use of the standard primipara, rather than the whole obstetric population, as the basis for inter-unit comparisons of maternity care will control for the substantial difference in case mix seen in different units, thereby increasing the validity of those comparisons. The technique has the additional benefit of clarifying the relationship between everyday clinical decision making and a unit's performance in comparative indicator reports. The approach must be combined with a separate study of the other groups in the case mix, such as multiparae and high risk primiparae. Additional nonoverlapping groups, homogeneous in terms of risk factors, should be defined and used to extend the basis on which comparisons may be made.
机译：目的：评估标准初产妇（具有相对较低风险或干预作用且不良结局的产科人群的子集）在单位间比较产妇护理过程和结果指标的适用性。设计：从圣玛丽产妇信息系统上定期收集的计算机数据中得出的10项产科干预和不良预后指标之间的比较。地点：前西北泰晤士河地区有15个产妇单位。参加者：15,463名初产妇，1992年交付。主要观察指标：初产妇在标准定义范围内的比例。与其他初产妇相比，标准初产妇与较低干预率和不良结局相关的程度。结果：在数据库中，所有初产妇中有42.6％是标准的，比率从25.9％到57.7％不等。正如预期的那样，标准的初产妇比其他初产妇受到干预或不良后果的风险要小。对于10个指标中的至少四个指标，标准定义中除一个组成变量外的所有变量均是重要的危险因素。在单位内，标准和非标准primiparae的指标比率在统计学上有显着差异。在标准组中，单位之间的干预率和不良结局之间存在显着差异。在较高风险的非标准组中干预水平较高的单位在标准组中也具有较高干预水平。结论：使用标准的初产妇而不是整个产科人群作为产妇保健单位间比较的基础将控制不同单位中病例组合的实质差异，从而提高这些比较的有效性。该技术的另一个好处是在比较指标报告中阐明了日常临床决策与单位绩效之间的关系。该方法必须与病例组合中其他人群的单独研究相结合，例如多参数和高风险原始参数。应该定义在风险因素方面均相同的其他不重叠的组，并将其用于扩展进行比较的基础。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号