[Analysis of the Agency for Healthcare Research and Quality Patient Safety Indicators in public hospitals of the Autonomous Region of Madrid (Spain)]

Abstract

Objective: To identify variability in the Patient Safety Indicators (PSI) of the Agency for Healthcare Research and Quality (AHRQ) among hospitals and by hospital level in the Madrid Health Service and to evaluate the contribution of the minimum basic data set (MBDS) records to the variability observed.

Methods: Data on healthcare resources were obtained from the Specialized Care Information System and from MBDS records for 2006 from 20 public and state-assisted hospitals within the Madrid Health System. AHRQ PSI were obtained from the Health Information Area of the Madrid Health Council. Data analysis included correlation coefficients and multiple linear regression.

Results: Surgical complications and complications due to medical or postsurgical care showed significant differences among hospitals and by hospital level. These differences were positively associated with values in some of the MBDS records. We found correlations above 0.78 between decubitus ulcer and the average weight of medical diagnosis-related groups (DRG) and between failure to rescue and average length of hospital stay and the overall average weight. At least three of the variables analyzed explained the variability in decubitus ulcer, death in low-mortality DRGs and failure to rescue.

Conclusions: The variability found in the Madrid Health System for the PSI is high and is associated with certain records of the MBDS. These findings should be confirmed in successive studies and in other regions, and the possible contribution of some variables of the MBDS to this variability should be assessed.