Cross-sectoral comparisons of process quality indicators of health care across residential regions using restricted mean survival time

Šinkovec, Hana (avtor), Gall, Walter E. (avtor), Heinze, Georg (avtor)

Background: Practice guidelines recommend patient management based on scientific evidence. Quality indicators gauge adherence to such recommendations and assess health care quality. They are usually defined as adverse event rates, which may not fully capture guideline adherence over time. Methods: For assessing process indicators where compliance to the recommended treatment can be assessed by evaluating a patient's trace in linked routine databases, we propose using restricted mean survival time or restricted mean time lost, which are applicable even in competing risk situations. We demonstrate their application by assessing the compliance of patients with acute myocardial infarction (AMI) to high-power statins over 12 months in Austria’s political districts, using pseudo-observations and employing causal inference methods to achieve regional comparability. Results: We analyzed the compliance of 31,678 AMI patients from Austria’s 116 political districts with index AMI between 2011 and 2015. The results revealed considerable compliance variations across districts but also plausible spatial similarities. Conclusions: Restricted mean survival time and restricted mean time lost provide interpretable estimates of patients’ expected time in compliance (lost), well-suited for risk-adjusted entity comparisons in the presence of (measurable) confounding, censoring, and competing risks.

• Jezik: Angleški jezik
• Ključne besede: health care provider comparisons, pseudo-observations, risk adjustment, restricted mean survival time, restricted mean time lost
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.01 - Izvirni znanstveni članek
• Organizacija: BF - Biotehniška fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2024
• Št. strani: Str. 748-756
• Številčenje: Vol. 62, no. 11
• PID: 20.500.12556/RUL-164077
• UDK: 61
• ISSN pri članku: 0025-7079
• DOI: 10.1097/MLR.0000000000002057
• COBISS.SI-ID: 211696643
• Datum objave v RUL: 16.10.2024

Gradivo je del revije

• Naslov: Medical care
• Skrajšan naslov: Med. care
• Založnik: Lippincott
• ISSN: 0025-7079
• COBISS.SI-ID: 25921280

Licence

• Licenca: CC BY 4.0, Creative Commons Priznanje avtorstva 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by/4.0/deed.sl
• Opis: To je standardna licenca Creative Commons, ki daje uporabnikom največ možnosti za nadaljnjo uporabo dela, pri čemer morajo navesti avtorja.

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: kakovost zdravstvene oskrbe, ponudniki zdravstvenih storitev, pseudo-opazovanja, prilagoditev tveganja

Projekti

• Financer: Drugi - Drug financer ali več financerjev
• Program financ.: Main Association of the Austrian Social Security Institutions
• Naslov: Fundation