Search PubMed⌕ Search

Biomedical subjects

Jan Mainz

Publications and source records attributed to Jan Mainz.

25 records · Page 2Linked to original sources
PubMed2003

Defining and classifying clinical indicators for quality improvement.

OBJECTIVE: This paper provides a brief review of definitions, characteristics, and categories of clinical indicators for quality improvement in health care. ANALYSIS: Clinical indicators assess particular health structures, processes, and outcomes. They can be rate- or mean-based, providing a quantitative basis for quality improvement, or sentinel, identifying incidents of care that trigger further investigation. They can assess aspects of the structure, process, or outcome of health care. Furthermore, indicators can be generic measures that are relevant for most patients or disease-specific, expressing the quality of care for patients with specific diagnoses. CONCLUSIONS: Monitoring health care quality is impossible without the use of clinical indicators. They create the basis for quality improvement and prioritization in the health care system. To ensure that reliable and valid clinical indicators are used, they must be designed, defined, and implemented with scientific rigour.

Humans↗
PubMed2003

Developing evidence-based clinical indicators: a state of the art methods primer.

OBJECTIVE: To describe steps in developing and testing clinical indicators based on state of the art methods in previous literature and experience in the Danish National Indicator Project. ANALYSIS: The development process includes a planning phase, where the clinical area to be evaluated is chosen and the measurement team selected and organized. The planning phase is followed by a development phase where clinical indicators are prioritized and selected by the measurement team on the basis of documentation and knowledge from the scientific literature. When clinical indicators have been selected, specific measure specifications should be designed, including inclusion and exclusion criteria for the target population, description of a risk adjustment strategy, identification of data sources, description of data collection procedures, and an analytical plan for data analyses. Before clinical indicators are implemented they should be tested for reliability and validity. Preliminary tests may identify areas requiring further modifications and specifications of the indicators. CONCLUSION: Using clinical indicators for quality assessment represents an important approach to documenting the quality of care. Consumers of indicator information (clinicians, administrators, purchasers, regulators, and patients) need reliable and valid information for benchmarking, making judgments, and determining priorities, accountability and quality improvement. This underlines the fact that clinical indicators must be developed and tested with scientific rigor in a transparent process.

Benchmarking↗
PubMed2002

[Shared care--integrated cooperation across the sector boundaries about patient's course. Modern health care system cooperates].

Shared care programmes have been introduced in Denmark for areas, such as diabetes, asthma, and dementia. Over a three-year period, the communication and co-operation between the health sectors have improved. Specific demands on hospital referral and discharge letters have resulted in improved quality of contents and structure. This review shows that there is limited ongoing research on shared care and that the end points including formulations like "improved co-operation" have been too broad. Almost no research is available on specific improvements obtained by shared care. The study shows that implementation of shared care research programmes with specific end points is very extensive. Only 10 per cent of the present studies have specific end points, and 75 per cent of these show positive effects of shared care programmes. The GP Consulting System in Denmark has proved most useful in the progress of shared care. Future research in shared care should focus on specific end points, in which analyses of patient's course are fundamental in an effort to obtain improvements.

Community Health Services↗
PubMed2002

Impact of delay on diagnosis and treatment of primary lung cancer.

Lung cancer continues to be a devastating disease that defies nearly all the therapeutic endeavours to improve the 5-year survival. Survival is determined to a large extent by age, morphology and stage. Early presymptomatic detection by screening has as yet failed to demonstrate any effect of such programmes. At the moment, medical healthcare units invest a significant proportion of their resources to eliminating waiting times in diagnosis and treatment in order to improve outcome. The aim of this literature review is to investigate whether waiting times and delays have any bearing on prognosis and treatment. Specifically, the hypothesis is raised that longer delays are associated with poorer survival or more advanced stage disease and may explain the poorer survival rate. Large-scale cohort studies within well-defined catchment areas are required both to establish the prognostic impact of delays and to understand the natural progression of lung cancers.

Diagnosis, Differential↗
PubMed2002

Patient and GP agreement on aspects of general practice care.

OBJECTIVE: The aim of the present study was to compare patient and GP priorities for general practice care. METHODS: A questionnaire survey was carried out in general practice in Denmark which included 900 consecutive patients aged over 18 years from 15 practices collected in 1995, and 919 randomly sampled GPs in 1999. The postal questionnaire, developed by the EUROPEP group, contained 40 questions about eight aspects of primary care. Participants were asked to state their priorities for each question ranging from "not at all important" to "most important". A reminder questionnaire was sent to non-responders after 2 weeks. Top priority percentages ("very/most important") were calculated for each question as were differences between participant groups. RESULTS: Questionnaires were answered by 771 (85.7%) patients and 584 (64.2%) GPs. Their priorities were highly correlated (r = 0.754, P < 0.001). Patients gave higher priority than GPs to availability and accessibility of the practice and seeing the same GP. The GP should be capable of providing information on illness, investigations and treatments and patient associations, and should know the patient's history and be regularly updated through courses. CONCLUSIONS: Patient and GP priorities for primary care were highly correlated. The higher priority awarded by patients than by GPs to specific aspects of primary care should be acknowledged when organizing and developing general practice.

Adult↗
PubMedDate not supplied

Determinants of priorities and satisfaction in pediatric care.

AIMS: To investigate determinants of parents' priorities and satisfaction in relation to pediatric inpatient care and to examine the relationship between fulfillment of expectations and satisfaction. METHODS: The study took place in a pediatric acute care inpatient department with 300 parents of children admitted consecutively. Data were collected by means of two self-administered questionnaires. Parents completed one questionnaire immediately after their child's admission and the second after hospital discharge. RESULTS: Having confidence in the doctors, getting answers to questions about care and treatment, and being satisfied with the nurses' and doctors' behavior, were found to be determinants of having a satisfaction score above average. Waiting time was a relatively weak determinant of being satisfied in general, although a short waiting time was one of the items given the highest priority score.

Adolescent↗