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>Journals >Medicina Crítica >Year 2009, Issue 4


Sánchez VLD
Winner to Prize «Dr. Mario Shapiro»
Quality of medical care I mexican ICU´s. Multicenter

Rev Asoc Mex Med Crit y Ter Int 2009; 23 (4)

Language: Español
References: 93
Page: 187-198
PDF: 237.70 Kb.


Full text




ABSTRACT

Background: National Intensive Care units lack a system of performance evaluation. Our team has validated methodological tools and now we intend to use them to design it.
Objectives: To develop indicators of quality of care in the national ICU’s and set their critical limits.
Patients and methods: Design: Prospective cohort. Sites: 22 ICU’s. Period: 6 years. Patients: 15 years or older. Variables: Clinical, APACHE II, Brussels score and NEMS. Statistical analysis: Descriptive and graphics of correlation between indexes of clinical and economical performances.
Results: 11,681 patients were enrolled, 52.4% men. Mean age was 53.1 ± 18.8 years. APACHE II was 14.1 ± 6.9. SMR was 1.26. Remarkable indicators were longlength fast in 33.0%, MODS in 31.7%, long length of stay in 24.6%, dissatisfaction with the service in 23.5% and ARF in 21.5%. In the graphics of performance, government institutions showed an appropriate use of resources. Private institution showed lower mortality with less use of resources. Most of the centers (72.7%) had an acceptable relationship between both indexes.
Conclusions: Indicators of quality of care in Mexican ICU are described and two methods of evaluation are proposed.


Key words: Cost-benefit analysis, cost-control, critical care, health care, hospital mortality, Intensive Care Units, length of stay, outcome assessment, quality assurance, quality of health care.


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