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  1. Confidential inquiry into quality of care before admission to intensive care.

    Article - En anglais

    Objective 

    To examine the prevalence, nature, causes, and consequences of suboptimal care before admission to intensive care units, and to suggest possible solutions.

    Design 

    Prospective confidential inquiry on the basis of structured interviews and questionnaires.

    Setting 

    A large district general hospital and a teaching hospital.

    Subjects 

    A cohort of 100 consecutive adult emergency admissions, 50 in each centre.

    Main outcome measures 

    Opinions of two external assessors on quality of care especially recognition, investigation, monitoring, and management of abnormalities of airway, breathing, and circulation, and oxygen therapy and monitoring.

    Results 

    Assessors agreed that 20 patients were well managed (group 1) and 54 patients received suboptimal care (group 2).

    Assessors disagreed on quality of management of 26 patients (group 3).

    The casemix and severity of illness, defined by the acute physiology and chronic health evaluation (APACHE II) score, were similar between centres and the three groups.

    In groups 1,2, and 3 intensive care mortalities were 5 (25%)), 26 (48%), and 6 (23%) respectively (P=0.04) (group I versus group 2, P=0.07).

    Hospital mortalities were 7 (35%), 30 (56%), and 8 (31%) (P=0.07) and standardised hospital mortality ratios (95% confidence intervals) were 1.23 (0.49 to 2.54), 1.4 (0.94 to 2.0), and 1.26 (0.54 to 2.48) respectively.

    Admission to intensive care was considered late in 37 (69%,) patients in group 2. Overall, a minimum of 4. (...)

    Mots-clés Pascal : Soin intégré, Enquête opinion, Confidentialité, Facteur qualité, Etude cohorte, Prévalence, Soin intensif, Etiologie, Prospective, Evaluation, Homme, Angleterre, Grande Bretagne, Royaume Uni, Europe, Organisation santé

    Mots-clés Pascal anglais : Managed care, Opinion inquiry, Confidentiality, Q factor, Cohort study, Prevalence, Intensive care, Etiology, Prospective, Evaluation, Human, England, Great Britain, United Kingdom, Europe, Public health organization

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0301130

    Code Inist : 002B30A04D. Création : 27/11/1998.