Bayesian methods in reporting and managing Australian clinical indicators

来源 :World Journal of Clinical Cases | 被引量 : 0次 | 上传用户:mingxing10192009
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Sustained clinical improvement is unlikely without appropriate measuring and reporting techniques. Clinical indicators are tools to help assess whether a standard of care is being met. They are used to evaluate the potential to improve the care provided by healthcare organisations(HCOs). The analysis and reporting of these indicators for the Australian Council on Healthcare Standards have used a methodology which estimates, for each of the 338 clinical indicators, the gains in the system that would result from shifting the mean proportion to the 20 th centile. The results are used to provide a relative measure to help prioritise quality improvement activity within clinical areas, rather than simply focus on “poorer performing” HCOs. The method draws attention to clinical areas exhibiting larger between-HCO variation and affecting larger numbers of patients. HCOs report data in six-month periods, resulting in estimated clinical indicator proportions which may be affected by small samples and sampling variation. Failing to address such issues would result in HCOs exhibiting extremely small and large estimated proportions and inflated estimates of the potential gains in the system. This paper describes the 20 th centile method of calculating potential gains for the healthcare system by using Bayesian hierarchical models and shrinkage estimators to correct for the effects of sampling variation, and provides an example case in Emergency Medicine as well as example expert commentary from colleges based upon the reports. The application of these Bayesian methods enables all collated data to be used, irrespective of an HCO’s size, and facilitates more realistic estimates of potential system gains. Sustained clinical improvement is unlikely without appropriate measuring and reporting techniques. Clinical indicators are tools to help assess whether a standard of care is being met. They are to evaluate the potential to improve the care provided by healthcare organizations (HCOs). The analysis and reporting of these indicators for the Australian Council on Healthcare Standards have used a methodology which estimates, for each of the 338 clinical indicators, the gains in the system that would result from shifting the mean proportion to the 20 th centile. The results are used to provide a relative measure to help prioritize quality improvement activity within clinical areas, rather than simply focus on “poorer performing” HCOs. The method draws attention to clinical areas exhibiting larger between-HCO variations and affecting larger numbers of patients. in six-month periods, resulting in estimated clinical indicator proportions which may be affected by small samp les and sampling variation. Failing to address such issues would result in HCOs exhibiting extremely small and large estimated proportions and inflated estimates of the potential gains in the system. This paper describes the 20 th centile method of calculating potential gains for the healthcare system by using Bayesian hierarchical models and shrinkage estimators to correct for the effects of sampling variation, and provides an example case in Emergency Medicine as well as example expert commentary from colleges based upon the reports. The application of these Bayesian methods enables all collated data to be used, irrespective of an HCO’s size, and facilitates more realistic estimates of potential system gains.
其他文献
湖北省咸丰县位于武陵山区,已经属于西部地区,老百姓住的相对比较分散,因此更加需要建立上下联动的分工协作机制,更加需要县级公立医院改革强调公益性,强调县乡一体化,强调分
专性的昆虫包囊病毒ascoviruses包含一个大小为119-186kbp的环状DNA基因组。因包囊病毒感染昆虫无明显的可辨别症状,它们最近才被发现。广谱性化学农药的广泛应用降低了寄生
黄河万家寨水利枢纽有限公司是随着国家开发黄河北干流的第一个骨干工程——万家寨水利枢纽工程的建设而组建的。公司是由 The Yellow River Wanjiazhai Water Control Proj
本研究成功地在石墨衬底上制备了低维ZnO材料,即一维的ZnO纳米棒和二维的ZnO薄膜。采用X射线衍射、场发射扫描电镜、光致发光谱和反射谱等测量技术对石墨衬底上制备的低维ZnO
目的调查镇江地区近2年小儿意外伤害的特点及其相关因素,探讨预防意外伤害的方法。方法回顾性分析江苏大学附属人民医院急诊医学中心接诊的711例小儿意外伤害患儿的种类、构
所谓文献信息,顾名思义是指用文字、图像、声频、视频等手段记录于一定物质载体上的信息,是原始信息资源一级开发利用的结果,是综合记录、系统反映自然、社会和人类活动的工
雀麦,老百姓俗称野麦子。近两年危害越来越大,严重地块造成小麦减产50%,甚至毁种或倒茬。防除小麦田雀麦成为老百姓亟须解决的问题。实践证明,70%氟唑磺隆(彪虎)是防治雀麦的
2011年4月19日,晋级全球第一大汽车市场的中国将迎来一场让全球瞩目的汽车盛会:第十四届上海国际车展。本届上海国际车展以“创新未来”为主题,将着眼点放在了未来,而对于百
采用水热法在不加任何助剂的情况下制备了六方纤锌矿ZnO及掺杂钐的ZnO(ZnO:Sm)粉体材料.气敏测试结果显示,ZnO:Sm材料对二甲胺具有较高的灵敏度,随着二甲胺浓度增加,灵敏度呈
期刊