Increased nursing-time requirements due to pressure sores in long-term-care residents in Quebec.

Objective: To test the hypothesis that pressure sores significantly influence the nursing workload, after taking confounding factors into account, i.e., patients' characteristics simultaneously associated with the occurrence of pressure sores and the nursing-time requirements.

Practical considerations on the use of the Charlson comorbidity index with administrative data bases.

To develop a measure of the burden of comorbid disease from the MED-ECHO data base (Québec), the so-called Charlson index was adapted to International Classification of Disease (ICD-9) codes. The resulting comorbidity index was applied to the study of inpatient death in 33,940 patients with ischemic heart disease. Multiple logistic regression was used to relate inpatient death to its predictors, including gender, principal diagnosis, age, and the comorbidity index.

The diluting effect of medical work groups on feedback efficacy in changing physician's practice.

Feedback intervention has been advocated as a successful method to modify the way that physicians practice medicine. However, most studies concerned with modifying physician profiles have focused on interns and residents. The results presented here concern regular staff and therefore provide a better basis for generalization.

Using the handicap code of the ICIDH for classifying patients by intensity of nursing care requirements.

An 11-class patient classification system (PCS) has been built on a recode of two dimensions of the handicap code of the ICIDH: physical independence and mobility handicaps. The proposed system, called MAC XI, explains 78% of the variance of nursing care hours required by nursing-home residents and extended-care hospital patients. This percentage of variation is higher than the one explained by traditional dependency grids such as the Exton-Smith, Murphy, Kuntzmann and SMAF.

Sex bias in the management of coronary artery disease in Quebec.

This study tests the hypothesis that, given the absence of financial barriers to major coronary procedures in Quebec, women are as likely as men to undergo such procedures. The use of coronary procedures in 33,940 patients with ischemic heart disease, admitted during 1 year to 78 Quebec hospitals, was analyzed. The male-to-female age- and severity-adjusted odds ratios for the use of these procedures were 1.