Non-indicated vitamin B- and D-testing among Dutch hospital clinicians: a cross-sectional analysis in data registries.

Objectives: To assess the extent of non-indicated vitamin B- and D-testing among Dutch clinicians and its variation among hospitals.

Design: Cross-sectional study using registration data from 2015 to 2019.

Participants: Patients aged between 18 and 70 years who received a vitamin B- or D-test.

The sound of Parkinson's disease: A model of audible bradykinesia.

Introduction: Evaluation of bradykinesia is based on five motor tasks from the MDS-UPDRS. Visually scoring these motor tasks is subjective, resulting in significant interrater variability. Recent observations suggest that it may be easier to hear the characteristic features of bradykinesia, such as the decrement in sound intensity or force of repetitive movements.

Standardized mortality ratios for regionalized acute cardiovascular care.

Background: Standardized Mortality Ratios (SMRs) are case-mix adjusted mortality rates per hospital and are used to evaluate quality of care. However, acute care is increasingly organized on a regional level, with more severe patients admitted to specialized hospitals. We hypothesize that the current case-mix adjustment insufficiently captures differences in case-mix between non-specialized and specialized hospitals.

Association between public media and trends in new acute coronary syndrome presentations during the first COVID‑19 wave in the Netherlands.

Background: We aimed to evaluate the association between public media and trends in new presentations of acute coronary syndrome (ACS) during the first wave of the coronavirus disease 2019 (COVID‑19) in the Netherlands.

Methods: New ACS presentations per week in 73 hospitals during the first half of 2019 and 2020 were retrieved from the national organisation Dutch Hospital Data and incidence rates were calculated. Stratified analyses were performed by region, type of ACS and patient characteristics.

What is the impact on the readmission ratio of taking into account readmissions to other hospitals? A cross-sectional study.

Objectives: Readmissions are used widespread as an indicator of the quality of care within hospitals. Including readmissions to other hospitals might have consequences for hospitals. The aim of our study is to determine the impact of taking into account readmissions to other hospitals on the readmission ratio.

Can differences in length of stay between Dutch university hospitals and other hospitals be explained by patient characteristics? A cross-sectional study.

Objectives: The indicator unexpectedly long length of stay (UL-LOS) is used to gain insight into quality and safety of care in hospitals. The calculation of UL-LOS takes patients' age, main diagnosis and main procedure into account. University hospitals have relatively more patients with a UL-LOS than other hospitals.

To what degree can variations in readmission rates be explained on the level of the hospital? a multilevel study using a large Dutch database.

Background: It is not clear which part of the variation in hospital readmissions can be attributed to the standard of care hospitals provide. This is in spite of their widespread use as an indicator of a lower quality of care. The aim of this study is to assess the variation in readmissions on the hospital level after adjusting for case-mix factors.

Re-admission patterns in England and the Netherlands: a comparison based on administrative data of all hospitals.

Background: Examining variation in patterns of re-admissions between countries can be valuable for mutual learning in order to reduce unnecessary re-admissions. The aim of this study was to compare re-admission rates and reasons for re-admissions between England and the Netherlands.

Methods: We used data from 85 Dutch hospitals (1 355 947 admissions) and 451 English hospitals (5 260 227 admissions) in 2014 (96% of all Dutch hospitals and 100% of all English NHS hospitals).

How to identify potentially preventable readmissions by classifying them using a national administrative database.

Importance: Hospital readmissions are being used increasingly as an indicator of quality of care. However, it remains difficult to identify potentially preventable readmissions.

Objectives: To evaluate the identification of potentially preventable hospital readmissions by using a classification of readmissions based on administrative data.

Trends in hospital and intensive care admissions in the Netherlands attributable to the very elderly in an ageing population.

Introduction: The Dutch population is ageing and it is unknown how this is affecting trends in the percentage of hospital and intensive care unit (ICU) admissions attributable to patients aged 80 years or older, the very elderly.

Methods: We present data on the percentage of the very elderly in the general population and the percentage of hospital admissions attributable to the very elderly. We subsequently performed a longitudinal cross-sectional study on ICU admissions from hospitals participating in the National Intensive Care Evaluation registry for the period 2005 to 2014.

Unexpectedly long hospital stays as an indicator of risk of unsafe care: an exploratory study.

Objectives: We developed an outcome indicator based on the finding that complications often prolong the patient's hospital stay. A higher percentage of patients with an unexpectedly long length of stay (UL-LOS) compared to the national average may indicate shortcomings in patient safety. We explored the utility of the UL-LOS indicator.

A pilot study on record reviewing with a priori patient selection.

Objectives: To investigate whether a priori selection of patient records using unexpectedly long length of stay (UL-LOS) leads to detection of more records with adverse events (AEs) compared to non-UL-LOS.

Design: To investigate the opportunities of the UL-LOS, we looked for AEs in all records of patients with colorectal cancer. Within this group, we compared the number of AEs found in records of patients with a UL-LOS with the number found in records of patients who did not have a UL-LOS.