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

Saskia E. Drösler, Niek S. Klazinga, Patrick S Romano, Daniel J Tancredi, Maria A. Gogorcena Aoiz, Moira C. Hewitt, Sarah Scobie, Michael Soop, Eugene Wen, Hude Quan, William A. Ghali, Soeren Mattke, Edward Kelley

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

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. Data sources. Routine hospitalization-related administrative data from seven countries were analyzed. Using algorithms adapted to the diagnosis and procedure coding systems in place in each country, authorities in each of the participating countries reported summaries of the distribution of hospital-level and overall (national) rates for each AHRQ Patient Safety Indicator to the OECD project secretariat. Results. Each country's vector of national indicator rates and the vector of American patient safety indicators rates published by AHRQ (and re-estimated as part of this study) were highly correlated (0.821-0.966). However, there was substantial systematic variation in rates across countries. Conclusions. This pilot study reveals that AHRQ Patient Safety Indicators can be applied to international hospital data. However, the analyses suggest that certain indicators (e.g. 'birth trauma', 'complications of anesthesia') may be too unreliable for international comparisons. Data quality varies across countries; undercoding may be a systematic problem in some countries. Efforts at international harmonization of hospital discharge data sets as well as improved accuracy of documentation should facilitate future comparative analyses of routine databases.

Original languageEnglish (US)
Pages (from-to)272-278
Number of pages7
JournalInternational Journal for Quality in Health Care
Volume21
Issue number4
DOIs
StatePublished - 2009

Keywords

  • International classification of diseases
  • Patient safety
  • Quality indicators

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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    Drösler, S. E., Klazinga, N. S., Romano, P. S., Tancredi, D. J., Gogorcena Aoiz, M. A., Hewitt, M. C., Scobie, S., Soop, M., Wen, E., Quan, H., Ghali, W. A., Mattke, S., & Kelley, E. (2009). Application of patient safety indicators internationally: A pilot study among seven countries. International Journal for Quality in Health Care, 21(4), 272-278. https://doi.org/10.1093/intqhc/mzp018