TOP 20 - 2003 | IASIST | Informed decisions

We are presenting the fourth edition of the TOP 20 hospitals programme.

The participation of 139 hospitals in this edition, which was marked by responsibility for health services being assumed by Autonomous Communities which had not had this responsibility until then, represents an important degree of consolidation for this programme.

Aspects most emphasised in this edition

Methodology:

Modifications have been made in the methodology to improve the evaluation system. Working from the debate within the Scientific and Consultancy Commissions, the following improvements have been made to the programme methodology:

A new indicator in the care quality dimension: the index for readmission adjusted by risk (IRAR). This indicator is designed to score the rate of emergency readmissions within 30 days of leaving hospital which are related to problems derived from the first admission or deficits in patient monitoring and checks.

The substitution rate for surgery without admission is calculated from the MBDS data, identifying the surgical type (DRG) processes which might require outpatient treatment.

Clinical Areas - Heart Area Benchmarks

Iasist presents the Heart Area Benchmarks, a specific programme which evaluates two very frequent pathologies: congestive cardiac failure (CCF) and coronary ischemic disease, whether in medical/pharmacological treatment (acute myocardial infarction - AMI), percutaneous treatment (percutaneous transluminal coronary angioplasty-PTCA) or surgical treatment (coronary bypass). Ischemic cardiopathy is one of the most frequent causes of early death in Spain. On the other hand, heart failure is one of the main areas responsible for health consumption in older people.

119 centres were included in the Heart Area evaluation which treated a total of 93,127 episodes involving these processes. The indicators which were taken into account were, in all cases, mortality, rate of emergency re-admissions after 30 days and the average stay. In the surgical cases we added infection rates and post-surgical haemorrhage and the percentage of bypasses carried out with the mammary artery, a quality indicator which is highly rated by heart surgeons.