Transactions of the Twenty-Sixth Annual Meeting of the Society for Maternal-Fetal MedicineAre the Agency for Healthcare Research and Quality obstetric trauma indicators valid measures of hospital safety?
Section snippets
Data source and calculation of PSI rates
Using the Illinois Department of Public Health's hospital administrative database (UB92 format) from 2001, we identified, using diagnosis-related groups (DRGs) 370-375, all deliveries that occurred in nonfederal Illinois hospitals with more than 50 deliveries. Federal hospitals are not in the Illinois database, and we desired to analyze hospitals with an obstetric volume high enough to provide meaningful data. Published AHRQ ICD-9 coding criteria were then used to calculate hospital-specific
Results
During the year 2001, 175,374 deliveries from 142 Illinois hospitals met inclusion criteria and were available for analysis. The Figure illustrates the distribution of the obstetric trauma rates across the 142 hospitals. The mean PSI rates for the statewide sample were 203 per 1000 instrument-assisted vaginal deliveries (PSI 27), 52 per 1000 spontaneous vaginal deliveries (PSI 28), and 5 per 1000 cesarean deliveries (PSI 29). These rates are similar to the reported 2002 national rates of 237
Comment
In response to quality-of-care issues within the health care system, providers of health care have sought to establish benchmark measures to track and decrease rates of adverse events. One type of widely disseminated measure is the PSI developed by AHRQ, which potentially can be used to compare the frequency of complications over time within a hospital as well as cross-sectionally among hospitals. For obstetrical care, the PSI for maternal morbidity has been chosen to be obstetrical trauma, as
Acknowledgment
These data were presented as an abstract at the 26th annual meeting of the Society for Maternal-Fetal Medicine, 2006.
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Supported by an Excellence in Academic Medicine grant from the state of Illinois.
Presented at the 26th Annual Meeting of the Society for Maternal-Fetal Medicine, January 30 through February 4, 2006, Miami, FL.