Patients classification System

tools for
Cost management

tools for
Quality management

tools for
HOSPITAL PLANNING

4  Why to choose US

4  implementation

4  ANECDOTE

4  contact

4  Logic

4  diagnoses

4  procedures

4  inpatients

4  outpatients

4  insurance

4  readmissions

4  reoperations

4  complications

4  deaths

4  length of stay

4  day surgery

4  unjustified stays

POTENTIALLY AVOIDABLE REOPERATIONS – EXPECTED RATES

Adjustment variables

Clinical groups (see below), age, gender, programmed operation on admission day

Adjustment model

Negative binomial distribution, 95% confidence interval (p  2 , where p = rate, n = number of observations
expected rates are adjusted for
complexity, admission by transfer and specialty.

Reference population

138 Swiss hospitals fulfilling all data quality requirements for potentially avoidable reoperations4  data quality

1’820’817 eligible operations from 2009 to 2012

Table A. Some examples of expected reoperations rates (extract)

 

Risk groups

Expected
rate

Number of observations

Minimal
expected rate

Maximal expected rate

 

 

Intestinal tract procedures – very low risk (DIG-0)

   < 51 years old


0.003


16’163


0.002


0.004

 

 

   > 50 years old

0.006

25’549

0.005

0.007

 

 

Urogenital procedure – medium risk (URO-2)
   < 51 years old

0.019

3’920

0.015

0.023

 

 

   51-70 years old, programmed on the admission day

0.015

7’030

0.012

0.018

 

 

   51-70 years old, not programmed on the admission day

0.020

21’008

0.018

0.021

 

 

   >70 years old, programmed on the admission day

0.017

5’612

0.014

0.021

 

 

   >70 years old, not programmed on the admission day

0.026

23’184

0.024

0.028

 

 

Kidney transplantation (TRP-0)
   < 51 years old

0.086

456

0.060

0.111

 

 

   >50 years old

0.159

580

0.129

0.188

 

 

Other transplantations (TRP-1)

0.260

642

0.226

0.294

 

 

Table B. Clinical groups

Code and labels

SQLape® categories  :       4  PROCEDURES

CIR-0

Cardiovascular procedures – very low risk

ARC2, VAS2

CIR-1

Cardiovascular procedures – low risk

COR2

CIR-2

Cardiovascular procedures – medium risk

ARC3, VAL2, VAS3, VAS5

CIR-3

Cardiovascular procedures – high risk

GVA2

CIR-4

Cardiovascular procedures – very high risk

COR3, GVA3,VAS4, VAS6

CUT-1

Skin procedures – low risk

CUT1

CUT-2

Skin procedures – medium risk

CUT2

CUT-3

Skin procedures – high risk

CUT3, CUT4

DIG -0

Intestinal tract procedures – very low risk

ABD2, ABD3

DIG -1

Intestinal tract procedures – low risk

ANU2, APP2

DIG -2

Intestinal tract procedures – low/medium risk

ABD1, ABD4, ANU3, ANU4,

DIG -3

Intestinal tract procedures – high/medium risk

INT2, OES2, PER2, REC2, STO4

DIG -4

Intestinal tract procedures – high risk

ABD5, ANP2, DIA2, INC2, STO2, STO3, STO5

DIG -5

Intestinal tract procedures – very high risk

INC3, INC4, INT3, INT4, OES3, REC3

GYN-0

Gynecological procedures – low risk

UTE2, VUL2

GYN-1

Gynecological procedures –medium risk

UTE3, VUL3

GYN-2

Ovarian procedures – high risk

OVA2, OVA3

HEP-0

Hepatobiliary procedures – low risk

BIL2, HEP2

HEP-1

Hepatobiliary procedures – medium risk

BIL3, BIL4, HEP3,

HEP-2

Hepatobiliary procedures – high risk

BIL1, BIL5, PAN2,

LOC-0

Musculoskeletal procedures –  very low risk

DIG2, MAN3, OSS3, SCA3

LOC-1

Musculoskeletal procedures –  low risk

ART2, BRA3, BRA4, GEN2, GEN4, MAN2, MUS2, MUS3, OSS1, OSS2, OSS4, OSS5, SCA2

LOC-2

Musculoskeletal procedures –  medium risk

COL2, COX4, COX5, CRU2, CRU3, PED2, PED3

LOC-3

Musculoskeletal procedures –  high risk

ART3, COL3, COX2, COX3, DIG3, GEN3, OSS6,

LOC-4

Musculoskeletal amputation –  very high risk

CRU4, PED4

MAM-0

Breast procedure

MAM2, MAM3, MAM4, MAM5

NER-0

Nervous procedure – low risk

NER2

NER-1

Nervous procedure – high risk

NER3

NER-2

Spinal procedure

SPI2, SPI3

NER-3

Pituitary procedure

HYP-2

NER-4

Cerebral procedure

CER2, CER3, CRA2

OBS-0

Caesarean procedure

PAR2

OBS-1

Episiotomy and vaginal procedure

VAG2

OPH-0

Cataract procedure

CRY2

OPH-1

Low risk ophthalmic procedure

CAP3, CON3, OCU2, PAL2

OPH-2

Medium risk ophthalmic procedure

CAP2, CON2, OCU3, ORB2

OPH-3

High risk ophthalmic procedure

CAA2

ORL-0

ENT procedure – very low risk

AUE3, AUE4, DEN2, SAL2, TON2

ORL-1

ENT procedure – low risk

AUE2, AUE5, BUC2, NAS3, SIN2

ORL-2

ENT procedure – medium risk

BUC3, FAC2, FAC3, NAS4, PHA3,

ORL-3

ENT procedure – high risk

LAR2, LAR3, NAS2, PHA2

RES-0

Respiratory tract procedure – low risk

PUL2, THM2

RES-1

Respiratory tract procedure – medium risk

PUL4, TRA3, TRA4

RES-2

Respiratory tract procedure – high risk

PUL3, THO2

SAN-0

Blood procedure

LYM2, LYM3, SAN2

SAN-1

Spleen procedure

LIE-2

THR-0

Thyroid procedure

THR2, THR3

TRP-0

Kidney transplantation

REN5

TRP-1

Other transplantation

COR4, HEP4, PUL5

URO-0

Urogenital procedure – very low risk

PEN2, URE2

URO-1

Urogenital procedure – low risk

PEN3, TES2, TES3, URT2

URO-2

Urogenital procedure – medium risk

PRO2, PRO3, URT3, VES2

URO-3

Urogenital procedure – high risk

REN4, VES3, VES4

URO-4

Urogenital procedure – very high risk

REN2, REN3, URE3, VES5

© Yves Eggli and SQLape s.à.r.l. 2014. Last update: 27.05.2014