E U B I R O D c o n t r i b u t i o n s t o O - - PowerPoint PPT Presentation

SLIDE 1

E U B I R O D c

• n

t r i b u t i

• n

s t

• O

E C D p r

• j

e c t s 2 1 7 : s t a n d a r d i z e d d e f i n i t i

• n

s

• f

a mp u t a t i

• n

s a n d d i s t r i b u t e d a p p r

• a

c h t

• g

l

• b

a l h

• s

p i t a l p e r f

• r

ma n c e b e n c h ma r k i n g

Fabrizio Carinci Visiting Professor, University of Surrey, UK Adjunct Professor of Biostatistics, University of Bologna, Italy f.carinci@surrey.ac.uk

Bridge Health EUBIROD Network Meeting Nicosia, CYPRUS, Wed 20th - Sat 23rd September 2017

SLIDE 2

F a b r i z i

• C

a r i n c i

2

O E C D H e a l t h C a r e Q u a l i t y I n d i c a t

• r

s P r

• j

e c t

 U

n d e r t h e u m b r e l l a

• f

t h e O r g a n i s a t i

• n

f

• r

E c

• n
• m

i c C

• p

e r a t i

• n

a n d D e v e l

• p

m e n t ( O E C D ) , t h e ‘ H e a l t h C a r e Q u a l i t y I n d i c a t

• r

s ’ ( H C Q I ) P r

• j

e c t w a s i n i t i a t e d i n 2 1

 T

h e g e n e r a l

• b

j e c t i v e w a s t

• h

e l p M e m b e r S t a t e s ( M S ) i d e n t i f y p r i

• r

i t y a r e a s f

• r

q u a l i t y i mp r

• v

e me n t t

• p

r

• v

i d e a c h i e v a b l e s t a n d a r d s b y e x a m i n i n g r e s u l t s a m

• n

g b e s t p e r f

• r

m i n g c

• u

n t r i e s

 I

n 2 6 , t h e O E C D r e l e a s e d a c

• mmo

n c

• n

c e p t u a l f r a me w

• r

k f

• r

h e a l t h s y s t e m p e r f

• r

ma n c e . N e s t e d “ q u a l i t y m a t r i x ” w i t h v e r t i c a l d i me n s i

• n

s

• f

‘ e f f e c t i v e n e s s ’ , ‘ p a t i e n t s a f e t y ’ a n d ‘ r e s p

• n

s i v e n e s s / p a t i e n t

• c

e n t e r e d n e s s ' , h

• r

i z

• n

t a l l y s u b d i v i d e d a c c

• r

d i n g t

• l

e v e l s

• f

h e a l t h c a r e n e e d s

• v

e r t h e l i f e c y c l e : ‘ s t a y i n g h e a l t h y ’ f

• r

h e a l t h y s u b j e c t s , ‘ g e t t i n g b e t t e r ’ f

• r

p e

• p

l e a f f e c t e d b y a d i s e a s e , ‘ l i v i n g w i t h i l l n e s s

• r

d i s a b i l i t y ’ f

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t h

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e w i t h a c h r

• n

i c c

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d i t i

• n

a n d ‘ c

• p

i n g w i t h e n d

• f

l i f e ’ f

• r

t e r m i n a l p a t i e n t s .

SLIDE 3

F a b r i z i

• C

a r i n c i

3

C a r i n g f

• r

q u a l i t y i n h e a l t h , O E C D 2 1 7

h t t p s : / / w w w .

• e

c d .

• r

g / e l s / h e a l t h

• s

y s t e m s / C a r i n g

• f
• r
• Q

u a l i t y

• i

n

• H

e a l t h

• F

i n a l

• r

e p

• r

t . p d f

SLIDE 4

F a b r i z i

• C

a r i n c i

4

G u i d e l i n e s f

• r

L

• w

e r A m p u t a t i

• n

s i n D i a b e t e s , O E C D 2 1 3

SLIDE 5

F a b r i z i

• C

a r i n c i

5

SLIDE 6

F a b r i z i

• C

a r i n c i

6

R

• m

M a t e r i a l , H C Q I 2 1 4

SLIDE 7

F a b r i z i

• C

a r i n c i

7

G u i d e l i n e s f

• r

L

• w

e r A m p u t a t i

• n

s i n D i a b e t e s , O E C D 2 1 5

SLIDE 8

F a b r i z i

• C

a r i n c i

8 O E C D H e a l t h C a r e Q u a l i t y I n d i c a t

• r

s 2 1 5

R e s u l t s

• f

L

• w

e r E x t r e m i t y A m p u t a t i

• n

R a t e s i n D i a b e t e s

S t a n d a r d i z e d R a t e s b y C

• u

n t r y ( A g e ≥ 1 5 y r s ) , Y e a r 2 1 3

• r

l a s t y e a r a v a i l a b l e

SLIDE 9

F a b r i z i

• C

a r i n c i

9 O E C D H e a l t h C a r e Q u a l i t y I n d i c a t

• r

s 2 1 5

R e s u l t s

• f

L

• w

e r E x t r e m i t y A m p u t a t i

• n

R a t e s i n D i a b e t e s

S t a n d a r d i z e d R a t e s b y C

• u

n t r y ( A g e ≥ 1 5 y r s ) , Y e a r 2 1 3

• r

l a s t y e a r a v a i l a b l e

SLIDE 10

F a b r i z i

• C

a r i n c i

10

L

• w

e r e x t r e m i t y a m p u t a t i

• n

s i n d i a b e t e s : r e s u l t s

• f

M u l t i v a r i a t e M

• d

e l l i n g ( G e n e r a l i z e d E s t i m a t i n g E q u a t i

• n

s ) , O E C D 2

• 2

1 3

SLIDE 11

F a b r i z i

• C

a r i n c i

11

L

• w

e r e x t r e m i t y a m p u t a t i

• n

s i n d i a b e t e s , 2 1 5

S

• u

r c e : O E C D H e a l t h a t a G l a n c e 2 1 7

SLIDE 12

F a b r i z i

• C

a r i n c i

12

O E C D H C Q I P r

• j

e c t

• n

H

• s

p i t a l P e r f

• r

m a n c e B e n c h m a r k i n g

( h t t p : / / w w w .

• e

c d .

• r

g / h e a l t h / h e a l t h

• s

y s t e m s / h e a l t h

• m

e e t i n g s

• p

r e s e n t a t i

• n

s . h t m)

SLIDE 13

F a b r i z i

• C

a r i n c i

13

O E C D H C Q I P r

• j

e c t

• n

H

• s

p i t a l P e r f

• r

m a n c e B e n c h m a r k i n g

( h t t p : / / w w w .

• e

c d .

• r

g / h e a l t h / h e a l t h

• s

y s t e m s / h e a l t h

• m

e e t i n g s

• p

r e s e n t a t i

• n

s . h t m )

SLIDE 14

F a b r i z i

• C

a r i n c i

14

O E C D H C Q I P r

• j

e c t

• n

H

• s

p i t a l P e r f

• r

m a n c e B e n c h m a r k i n g

( h t t p : / / w w w .

• e

c d .

• r

g / h e a l t h / h e a l t h

• s

y s t e m s / h e a l t h

• m

e e t i n g s

• p

r e s e n t a t i

• n

s . h t m )

SLIDE 15

F a b r i z i

• C

a r i n c i

15

O E C D H C Q I P r

• j

e c t

• n

H

• s

p i t a l P e r f

• r

m a n c e B e n c h m a r k i n g

( h t t p : / / w w w .

• e

c d .

• r

g / h e a l t h / h e a l t h

• s

y s t e m s / h e a l t h

• m

e e t i n g s

• p

r e s e n t a t i

• n

s . h t m )

SLIDE 16

F a b r i z i

• C

a r i n c i

16

P r

• g

r e s s r e p

• r

t

• n

H

• s

p i t a l P e r f

• r

m a n c e R e p

• r

t i n g , O E C D 2 1 7

“ T h e O E C D h a s b e n e f i t t e d e n

• r

m

• u

s l y f r

• m

t h e g r

• u

n d b r e a k i n g w

• r

k

• f

e x i s t i n g i n t e r n a t i

• n

a l p r

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r a m s s u c h a s E u r

• H

O P E , E C H O a n d E U B I R O D , b

• t

h i n t e r ms

• f

me t h

• d
• l
• g

i c a l d e v e l

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me n t a n d d a t a c

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l e c t i

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p r

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e s s e s . Wh i l e t h e O E C D a p p r

• a

c h h a s d r a w n e x t e n s i v e l y f r

• m

t h e t e c h n i c a l s p e c i f i c a t i

• n

s u t i l i s e d i n t h e s e p r

• g

r a m , s

• m

e v a r i a t i

• n

s r e m a i n . B y c

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p a r i n g a n d c

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t r a s t i n g t h e s e a p p r

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c h e s , w

• r

k i s p r

• g

r e s s i n g c

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l a b

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a t i v e l y t

• b

r i n g a b

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t g r e a t e r h a r m

• n

i s a t i

• n

”

SLIDE 17

F a b r i z i

• C

a r i n c i

17

T h i r t y

• d

a y m

• r

t a l i t y a f t e r a d m i s s i

• n

t

• h
• s

p i t a l f

• r

A M I b a s e d

• n

p a t i e n t d a t a , 2 1 3

• 2

1 5 (

• r

n e a r e s t y e a r s )

O E C D H e a l t h a t a G l a n c e , 2 1 7

SLIDE 18

F a b r i z i

• C

a r i n c i

18

T h i r t y

• d

a y m

• r

t a l i t y a f t e r a d m i s s i

• n

t

• h
• s

p i t a l f

• r

A M I b a s e d

• n

p a t i e n t d a t a , 2 1 3

• 2

1 5 (

• r

n e a r e s t y e a r s ) , O E C D H e a l t h a t a G l a n c e , 2 1 7

SLIDE 19

F a b r i z i

• C

a r i n c i

19

N e w E U P r

• j

e c t , 2 1 8

• 2

2 1

“ T r a i n i n g H e a l t h C a r e P e r f

• r

m a n c e I n t e l l i g e n c e P r

• f

e s s i

• n

a l s t

• T

r a n s l a t e P

• p

u l a t i

• n

H e a l t h a n d S y s t e m s P e r f

• r

m a n c e D a t a i n t

• A

c t i

• n

a b l e K n

• w

l e d g e ” ( H E A L T H P R O S )

M a r i e C u r i e , I n n

• v

a t i v e T r a i n i n g N e t w

• r

k C

• n

s

• r

t i u m U n i v e r s i t y

• f

A m s t e r d a m A l l b

• r

g U n i v e r s i t y O p t i m e d i s U n i v e r s i t y

• f

S u r r e y S c u

• l

a S a n t ’ A n n a C

• r

v i n u s U n i v e r s i t y P a r t n e r s … U n i v e r s i t y

• f

D u n d e e

SLIDE 20

F a b r i z i

• C

a r i n c i

20

H e a l t h P r

• s

: R

• t

a t i n g P h D S t u d e n t s

H e a l t h P r

• s

w i l l e v a l u a t e t h e I T a n d s t a t i s t i c a l n e e d s i n a n i n t e g r a t e d m a n n e r , s e t t i n g t h e s t a n d a r d i z e d t e r m s

• f

r e f e r e n c e f

• r

d a t a b a s e d e s i g n , d e f i n i t i

• n

s , v a l i d a t i

• n

a n d t r a n s f

• r

m a t i

• n
• f

d a t a e l e m e n t s r e q u i r e d f

• r

b u i l d i n g q u a l i t y

• f

c a r e a n d

• u

t c

• m

e i n d i c a t

• r

s , a s w e l l a s s t r u c t u r i n g r

• b

u s t s t a t i s t i c a l m

• d

e l s f

• r

p e r f

• r

m a n c e e v a l u a t i

• n

. T h e s c h e m e w i l l b e e v a l u a t e d a c r

• s

s d i f f e r e n t n a t i

• n

a l f r a m e w

• r

k s i n S c

• t

l a n d , D e n m a r k a n d a c r

• s

s me mb e r s

• f

t h e E U B I R O D n e t w

• r

k E S R 1 1 P r

• j

e c t T i t l e : T h e i mp a c t

• f

a u t

• ma

t e d i n t e r n a t i

• n

a l c

• mp

a r i s

• n

s u s i n g r

• u

t i n e l a r g e s c a l e d a t a b a s e s t

• i

mp r

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e d i a b e t e s c a r e O b j e c t i v e s : T

• i

m p l e m e n t a n d a s s e s s t h e i m p a c t

• f

u s i n g a n a u t

• m

a t e d s y s t e m

• f

i n t e r n a t i

• n

a l c

• m

p a r i s

• n

s i n r

• u

t i n e p r a c t i c e . T h e s t u d y w i l l i n v e s t i g a t e t h e e f f e c t

• f

t a r g e t e d i n t e r v e n t i

• n

s ( i n c l u d i n g s m

• k

i n g c e s s a t i

• n

, g l y c a e m i c c

• n

t r

• l

, a n d v a s c u l a r r i s k m a n a g e m e n t , f

• t

c a r e , v a s c u l a r s u r g e r y ) a n d d i f f e r e n t

• r

g a n i z a t i

• n

a l a r r a n g e m e n t s ( i m p r

• v

e d a d h e r e n c e , r e d u c t i

• n
• f

v a s c u l a r r i s k , f r e q u e n c y

• f

v i s i t s , i n t e g r a t i

• n
• f

p r i m a r y / s p e c i a l i s t c a r e , m i n

• r

a m p u t a t i

• n

s , c

• n

t i n u i t y

• f

c a r e , e t c ) . L

• w

e r e x t r e m i t y c

• m

p l i c a t i

• n

s ( e g p e r i p h e r a l a r t e r i a l d i s e a s e , m a j

• r

a m p u t a t i

• n

s ) w i l l b e u s e d a s a p r i m a r y e n d p

• i

n t . A p p l i c a t i

• n

a r e a ( s ) : R e a c h i n g b e t t e r

• u

t c

• m

e s . E x p e c t e d R e s u l t s : D e f i n i n g n e w i n t e r n a t i

• n

a l s t a n d a r d s t

• a

u t

• m

a t e s y s t e m s p e r f

• r

m a n c e b e n c h m a r k i n g i n d i a b e t e s . P l a n n e d s e c

• n

d m e n t s : H

• s

t e d a t S U R R E Y . S e c

• n

d m e n t U N I D U N D ( ≥ 6 m

• n

t h s ) t

• w
• r

k

• n

t h e n a t i

• n

w i d e S c

• t

t i s h d a t a b a s e ( S C I

• F

I ) . Wo r k v i s i t t

• R

C G P ( ≤ 3 w e e k s ) t

• c
• l

l e c t v i e w s

• n

p e r f

• r

m a n c e f e e d b a c k d i r e c t l y f r

• m

i n d i v i d u a l c

• n

s u l t a n t s ; a n d w

• r

k v i s i t s t

• t

h e r c e n t r e s

• f

t h e E U B I R O D n e t w

• r

k ( m a x . 6 w e e k s ) t

• t

e s t t h e a p p l i c a t i

• n
• f

t h e a p p r

• a

c h i n d i f f e r e n t E u r

• p

e a n c

• n

t e x t s .