[Regional and gender variations in appendicectomy : Nationwide small-area development of operation rates in the time series].

Background: Previous analyses of small-area appendicectomy rates showed significantly higher regional differences in the frequency of operations in women than in men OBJECTIVE: This work proposes valid measures to represent regional variations and analyzes gender-specific changes of appendicectomy rates at the county level in the time series.

Material And Methods: Appendicectomy frequencies for 2014, 2016 and 2018 by gender and at the county level were taken from the DRG statistics. Regional variations were calculated and assessed using the systematic component of variation (SCV).

ICD-11 extension codes support detailed clinical abstraction and comprehensive classification.

Background: The new International Classification of Diseases-11th revision (ICD-11) succeeds ICD-10. In the three decades since ICD-10 was released, demands for detailed information on the clinical history of a morbid patient have increased.

Methods: ICD-11 has now implemented an addendum chapter X called "Extension Codes".

Evaluation of outcome relevance of quality indicators in the emergency department (ENQuIRE): study protocol for a prospective multicentre cohort study.

Introduction: Quality of emergency department (ED) care affects patient outcomes substantially. Quality indicators (QIs) for ED care are a major challenge due to the heterogeneity of patient populations, health care structures and processes in Germany. Although a number of quality measures are already in use, there is a paucity of data on the importance of these QIs on medium-term and long-term outcomes.

[Routine Data from Emergency Departments: Varying Documentation Standards, Billing Modalities and Data Custodians at an Identical Unit of Care].

Background: Currently, there is a big need for data on emergency department (ED) utilization in Germany. One reason is the ongoing reorganisation of emergency care. Possible sources are routine data that are being collected based on legal regulations.

Secondary data in diabetes surveillance - co-operation projects and definition of references on the documented prevalence of diabetes.

In addition to the Robert Koch Institute's health surveys, analyses of secondary data are essential to successfully developing a regular and comprehensive description of the progression of diabetes as part of the Robert Koch Institute's diabetes surveillance. Mainly, this is due to the large sample size and the fact that secondary data are routinely collected, which allows for highly stratified analyses in short time intervals. The fragmented availability of data means that various sources of secondary data are required in order to provide data for the indicators in the four fields of action for diabetes surveillance.

[Hospitalizations and amputations for diabetes mellitus-trends and small-area variation in Germany].

Background: Hospitalizations and lower limb amputations related to diabetes mellitus (DM) are considered to be potentially avoidable. Appropriate outpatient care of diabetes prevents complications. Rates on potentially avoidable hospitalizations for diabetes are core indicators of the German diabetes surveillance program.

[Quality of care analyses using ICD 11 : Detailed capture of treatment events].

The identification of treatment errors, the so-called "undesirable" or "critical incidents", is crucial for improving and developing the quality of care. The new International Statistical Classification of Diseases and Related Health Problems-ICD-11-supports a structured data collection in the context of the quality of care and patient safety. Documentation conceptually relies on the multiple coding of the three dimensions of a critical incident: harm, cause, and mode.

[Memorandum III, Part 3: Quality of Care and Patient Safety Research Methods].

The German Network for Health Services Research [Deutsches Netzwerk Versorgungsforschung e.V. (DNVF)] fosters the methodological quality of health services research studies by memoranda and other initiatives.

A World Health Organization field trial assessing a proposed ICD-11 framework for classifying patient safety events.

Objective: To assess the utility of the proposed World Health Organization (WHO)'s International Classification of Disease (ICD) framework for classifying patient safety events.

Setting: Independent classification of 45 clinical vignettes using a web-based platform.

Study Participants: The WHO's multi-disciplinary Quality and Safety Topic Advisory Group.

Impact of Disease Prevalence Adjustment on Hospitalization Rates for Chronic Ambulatory Care-Sensitive Conditions in Germany.

Objectives: To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons.

Data Sources/study Setting: County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative ambulatory diagnosis data were used.

Study Design: A retrospective cross-sectional study using in- and outpatient secondary data was performed.

How many diagnosis fields are needed to capture safety events in administrative data? Findings and recommendations from the WHO ICD-11 Topic Advisory Group on Quality and Safety.

Objective: As part of the WHO ICD-11 development initiative, the Topic Advisory Group on Quality and Safety explores meta-features of morbidity data sets, such as the optimal number of secondary diagnosis fields.

Design: The Health Care Quality Indicators Project of the Organization for Economic Co-Operation and Development collected Patient Safety Indicator (PSI) information from administrative hospital data of 19-20 countries in 2009 and 2011. We investigated whether three countries that expanded their data systems to include more secondary diagnosis fields showed increased PSI rates compared with six countries that did not.

ICD-11 for quality and safety: overview of the WHO Quality and Safety Topic Advisory Group.

This paper outlines the approach that the WHO's Family of International Classifications (WHO-FIC) network is undertaking to create ICD-11. We also outline the more focused work of the Quality and Safety Topic Advisory Group, whose activities include the following: (i) cataloguing existing ICD-9 and ICD-10 quality and safety indicators; (ii) reviewing ICD morbidity coding rules for main condition, diagnosis timing, numbers of diagnosis fields and diagnosis clustering; (iii) substantial restructuring of the health-care related injury concepts coded in the ICD-10 chapters 19/20, (iv) mapping of ICD-11 quality and safety concepts to the information model of the WHO's International Classification for Patient Safety and the AHRQ Common Formats; (v) the review of vertical chapter content in all chapters of the ICD-11 beta version and (vi) downstream field testing of ICD-11 prior to its official 2015 release. The transition from ICD-10 to ICD-11 promises to produce an enhanced classification that will have better potential to capture important concepts relevant to measuring health system safety and quality-an important use case for the classification.

Case definitions for acute myocardial infarction in administrative databases and their impact on in-hospital mortality rates.

Objective: To identify validated ICD-9-CM/ICD-10 coded case definitions for acute myocardial infarction (AMI).

Data Sources: Ovid Medline (1950-2010) was searched to identify studies that validated acute myocardial infarction (AMI) case definitions. Hospital discharge abstract data and chart data were linked to validate identified AMI definitions.

International comparability of patient safety indicators in 15 OECD member countries: a methodological approach of adjustment by secondary diagnoses.

Objective: To improve the international comparability of patient safety indicators based on administrative hospital data, adjustment of country-specific rates by a proxy measure of diagnostic coding intensity was tested.

Data Sources: Secondary data (numerator and denominator counts of patient safety indicators) based on adults discharged from acute care hospitals between 2006 and 2008 was used.

Study Design: A retrospective cross-sectional study using hospital administrative data was performed.

The development, evolution, and modifications of ICD-10: challenges to the international comparability of morbidity data.

Background: The United States is about to make a major nationwide transition from ICD-9-CM coding of hospital discharges to ICD-10-CM, a country-specific modification of the World Health Organization's ICD-10. As this transition occurs, the WHO is already in the midst of developing ICD-11. Given this context, we undertook this review to discuss: (1) the history of the International Classification of Diseases (a core information "building block" for health systems everywhere) from its introduction to the current era of ICD-11 development; (2) differences across country-specific ICD-10 clinical modifications and the challenges that these differences pose to the international comparability of morbidity data; (3) potential strategic approaches to achieving better international ICD-11 comparability.

Detection of postoperative respiratory failure: how predictive is the Agency for Healthcare Research and Quality's Patient Safety Indicator?

Background: Patient Safety Indicator (PSI) 11, or postoperative respiratory failure, was developed by the US Agency for Healthcare Research and Quality to detect incident cases of respiratory failure after elective operations through use of ICD-9-CM diagnosis and procedure codes. We sought to determine the positive predictive value (PPV) of this indicator.

Study Design: We conducted a retrospective cross-sectional study, sampling consecutive cases that met PSI 11 criteria from 18 geographically diverse academic medical centers on or before June 30, 2007.

Application of patient safety indicators internationally: a pilot study among seven countries.

Objective: To explore the potential for international comparison of patient safety as part of the Health Care Quality Indicators project of the Organization for Economic Co-operation and Development (OECD) by evaluating patient safety indicators originally published by the US Agency for Healthcare Research and Quality (AHRQ).

Design: A retrospective cross-sectional study.

Setting: Acute care hospitals in the USA, UK, Sweden, Spain, Germany, Canada and Australia in 2004 and 2005/2006.

[Are quality indicators derived from routine data suitable for evaluating hospital performance? First results using the AHRQ patient safety indicators in Germany].

Patients and health insurances are increasingly interested in the quality of care provided by hospitals. Quality indicators are often used to evaluate the quality of inpatient treatment. Most of these evaluations require the collection of additional data.