4 Art. 15 comma 25 bis. L.135/2012 For the purpose of National - - PowerPoint PPT Presentation

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4 Art. 15 comma 25 bis. L.135/2012 For the purpose of National - - PowerPoint PPT Presentation

Mar 29, 2024 404 likes •734 views

4 Art. 15 comma 25 bis. L.135/2012 For the purpose of National Outcome Ai fini della attivazione dei programmi nazionali di valutazione sull'applicazione delle norme di cui al presente articolo, il Ministero della Evaluation

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  • Art. 15 comma 25 bis. L.135/2012
  • Ai

fini della attivazione dei programmi nazionali di valutazione sull'applicazione delle norme di cui al presente articolo, il Ministero della salute provvede alla modifica ed integrazione di tutti i sistemi informativi del Servizio sanitario nazionale, anche quando gestiti da diverse amministrazioni dello Stato, ed alla interconnessione a livello nazionale di tutti i flussi informativi su base individuale. Il complesso delle informazioni e dei dati individuali così ottenuti e' reso disponibile per le attività di valutazione esclusivamente in forma anonima ai sensi dell'articolo 35 del decreto legislativo 23 giugno 2011, n. 118.

  • Il Ministero della salute si avvale dell'AGENAS per lo svolgimento delle

funzioni di valutazione degli esiti delle prestazioni assistenziali e delle procedure medico‐chirurgiche nell'ambito del Servizio sanitario nazionale. A tal fine, AGENAS accede, in tutte le fasi della loro gestione, ai sistemi informativi interconnessi del Servizio sanitario nazionale di cui al presente comma in modalità anonima.

For the purpose of National Outcome Evaluation programs, the Ministry of Health modifies and integrates all NHS informations systems on an individual basis….the National Agency for Regional Health Services has access to the interconnected information systems

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Outcome measures by Hospital/ Local Health Unit Audit tools Report Card by Hospital/ Local Health Unit ER Information System Pilot studies

The National Outcome Evaluation Programme measures the outcome variability among providers and/or health care local units in Italy

…it provides «warnings» for «relevant» differences in

  • utcomes….art.12 National regulation on

Health agreement /2014

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Distance Learning programme– PNE 65.322 Participants (12 months online)

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Coronary artery bypass graft (CABG): 30-day mortality. Italy 2012-13

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Audit ongoing on quality of data

Coronary artery bypass graft (CABG): 30-day mortality 2012-13 >5%

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Coronary artery bypass graft (isolated): 30-day mortality

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Clinical audit on heart surgery based on Outcome Data, Tuscany

Riccardo Tartaglia, MD, Eur-Erg Tommaso Bellandi, PhD, Eur-Erg

rischio.clinico@regione.toscana.it www.regione.toscana.it/rischioclinico

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Valvuloplasty: 30-day mortality. 2013

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Valvuloplasty: 30-day

  • mortality. 2013
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Valvuloplasty: 30-day mortality - Italy 2012-2013

Information for patients??? “the risk of dying in the month following valvuloplasty in the Fazzi hospital is about 11 times higher than the nearby clinic”

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Distance 5km 10 min

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Coronary artery bypass graft (CABG):; Volume of care and 30 days mortality Italy 2011

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Valvuloplasty: Volume of admissions 2013 HOSPITAL PROVIN CE REGION N Italia ITALIA 26645

  • Osp. V. Fazzi

LE PUGLIA 114 A.O.SSN Consorziale Policlinico BA PUGLIA 195 CCA S. Maria BA PUGLIA 307 CCA Anthea BA PUGLIA 396 CCA CBH Villa Bianca BA PUGLIA 310 CCA Città di Lecce LE PUGLIA 321 CCA Villa Verde SNC TA PUGLIA 136

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Coronary artery bypass graft (CABG):; Volume of

  • admissions. Italy 2013

26/112 hospitals >200/year

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30 day mortality after surgery for stomach cancer by volume of interventions

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30 DAY MORTALITY AFTER SURGERY FOR STOMACH CANCER:VOLUME OF INTERVENTIONS 108 / 662 hospitals (16%) > 20

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Health impact assessment volume of surgery by ward- 30 day mortality. PNE 2011

Surgery for stomach cancer by ward N % Ϯ Total 7650 5.4 > 10/year 4729 2.7 <= 10 /year 2921 9.7 Surgery for colon cancer by ward N % Ϯ Total 30231 5.0 > 25 /year 21466 3.2 <= 25/year 8765 9.6

283 2921 * 2.7 = 80

203 deaths

842 8765 * 3.2 = 278

564 deaths

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30 DAY MORTALITY AFTER SURGERY FOR STOMACH CANCER:VOLUME OF INTERVENTIONS 108 / 662 hospitals (16%) > 20

Information for policy makers???

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REGULATORY DOCUMENT ON QUALITATIVE, STRUCTURAL, TECNOLOCICAL AND QUANTITATIVE STANDARD OF HOSPITAL CARE

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VOLUME OF ADMISSIONS

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OUTCOME

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Laparoscopic cholecystectomy : complications within 30 days. Italy 2013

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Outcome measures by Hospital/ Local Health Unit Audit tools Report Card by Hospital/ Local Health Unit ER Information System Pilot studies

The outcome measures represent assessment tools to support clinical and

  • rganizational audit programs aimed at

improving both effectiveness, and safety in the NHS.

OUTCOME EVALUATION PROGRAMMES Education and training of healthcare professionals Patient empowerment Reporting and learning systems Policies and programmes on patient safety