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true "titulo" => "Safety Data for Safer Care: The Importance of International Consensus and Action" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "317" "paginaFinal" => "326" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Edward Kelley, Jesús M Aranaz" "autores" => array:2 [ 0 => array:3 [ "nombre" => "Edward" "apellidos" => "Kelley" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Jesús M" "apellidos" => "Aranaz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Agency for Healthcare Research and Quality, Rockville, MD, USA" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Department of Preventive Medicine, Sant Joan d'Alacant Teaching Hospital, Department of Public Health, History Science, and Gynecology, Miguel Hernández University of Elche, Elche, Alicante, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Safety Data for Safer Care: The Importance of International Consensus and Action" ] ] "pdfFichero" => "256v22n06a13113632pdf001.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec233252" "palabras" => array:3 [ 0 => "Seguridad de pacientes" 1 => "Indicadores de seguridad" 2 => "Calidad asistencial" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec233254" "palabras" => array:3 [ 0 => "Patient safety" 1 => "Safety indicators" 2 => "Quality care" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "Objetivo: El interés en la medida y en la evaluación de la calidad ha crecido considerablemente a través de las últimas 2 décadas debido a diversos factores, como el reconocimiento de la gran variabilidad existente en la práctica clínica, la mayor disponibilidad de evidencia de eficacia probada y la creciente preocupación sobre el costo y la calidad del cuidado de la salud. En particular, el interés ha crecido en asegurar que el cuidado de la salud sea seguro, sobre todo desde que en 2001 el Institute of Medicine (IOM) incluyera la seguridad como una más de las dimensiones de la calidad. Este interés en la seguridad no está relacionado con barreras internacionales o con las particularidades de "mayor desarrollo" o "menor desarrollo" de un país. Iniciativas internacionales del más alto nivel gubernamental, como las de la Organización para la Cooperación Económica y del Desarrollo (OCDE), el Proyecto de Indicadores de Calidad en Salud (HQIP) y su grupo de trabajo en Seguridad del Paciente o la de la Alianza mundial por la Seguridad del Paciente de la OMS, resaltan la necesidad de un convenio internacional para lograr un mayor aprendizaje sobre la seguridad del paciente. Sin embargo, poco se ha estado haciendo para mejorar la disponibilidad y la comparabilidad de los datos/indicadores acerca de la seguridad del paciente dentro y entre los países. Material y método: En este artículo, describimos el trabajo realizado por cuerpos nacionales como la Agencia para la Investigación y la Calidad de la Asistencia Sanitaria (AHRQ) de Estados Unidos y por organizaciones internacionales como la OCDE y la Alianza Mundial (OMS) para mejorar los datos de seguridad en la búsqueda de proveer un cuidado más seguro, a la vez que contrastamos con la información existente en España sobre esta misma cuestión. Resultados: La propuesta de la OCDE pretende identificar las medidas apropiadas para favorecer comparaciones en el ámbito internacional, aunque una serie de dificultades (disponibilidad de datos, aspectos éticos, organización de los sistemas) hace que el número de indicadores sugeridos se haya visto reducido. Los indicadores que propone la AHRQ, basándose en varias fuentes de información sólidas, ofrecen una visión más rica respecto a la seguridad del paciente en el ámbito nacional. En España, existen iniciativas para comparación internacional mediante los indicadores propuestos por la OCDE e, internamente, usando los propuestos por la AHRQ, basándose en el CMBD. Conclusiones: El desarrollo de los sistemas de datos sobre seguridad del paciente, tanto en el ámbito nacional como en el internacional, tiene aún un largo camino por recorrer. Un aspecto importante a considerar es la necesidad de involucrar a los pacientes y sus asociaciones en la recogida y registro de datos sobre seguridad del paciente." ] "en" => array:1 [ "resumen" => "Objective: Interest in comparative quality measurement and evaluation has grown considerably over the past two decades due to several factors, such as recognition of widespread variation in clinical practice, the increased availability of evidence on medical effectiveness, and increasing concern about the cost and quality of healthcare. Interest in ensuring that healthcare is safe has grown, particularly since 2001 when the Institute of Medicine (IOM) included patient safety as another quality dimension. This interest in safety is not limited by international borders or by classifications of "more developed" or "less developed" countries. International initiatives at the highest levels of government such as the Organization for Economic Cooperation and Development's (OECD) Health Care Quality Indicators Project and its Patient Safety Working Group, as well as the World Alliance for Patient Safety, highlight the need for international agreement to increase learning on patient safety. However, little is being done to improve the availability and comparability of data/indicators on patient safety within and between countries. Material and method: In this paper, we describe the work being done by national bodies such as the US Agency for Healthcare Research and Quality (AHRQ), and international organizations such as the OECD and the World Alliance (WHO) to improve safety data with a view to providing safer care. At the same time, we compare this with information existing in Spain on this same question. Results: The proposal by the OECD attempts to identify suitable measurements to enable comparisons at international level, although several difficulties (availability of data, ethical aspects, organization of the systems) mean that the number of indicators has been reduced. The indicators proposed by the AHRQ, based on several solid information sources, offer a much clearer vision as regards patient safety at national level. In Spain, there are initiatives for international comparisons using the indicators proposed by the OECD and, at national level, using the proposals by AHRQ, based on the MBDS (minimum basic data set). Conclusions: The development of patient safety data systems, both at national and international level, still has a long way to go. One important aspect to consider, is the need to involve patients and their associations in the collection and recording of data on patient safety." ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "Accroître la sécurité du système. Une stratégie integrée pour améliorer la sécurité des patients dans le système de santé Canadian (acceded 04/10/2007). National Steering Committee on Patient Safety. Available from: http://www.rcpsc.medical.org/french/publications/" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Accroître la sécurité du système. Une stratégie integrée pour améliorer la sécurité des patients dans le système de santé Canadian (acceded 04/10/2007). National Steering Committee on Patient Safety. Available from: http://www.rcpsc.medical.org/french/publications/" "idioma" => "fr" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Comité Directeur National sur la Sécurité des Patients." ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "Experiencias nacionales e internacionales en la gestión de riesgos: pasado, presente y futuro. In: Aranaz JM, Vitaller J and Grupo de Estudio del Proyecto IDEA. Identificación de efectos adversos. De las complicaciones y efectos adversos a la gestión de los riesgos de la asistencia sanitaria. Valenc" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Experiencias nacionales e internacionales en la gestión de riesgos: pasado, presente y futuro. In: Aranaz JM, Vitaller J and Grupo de Estudio del Proyecto IDEA. Identificación de efectos adversos. De las complicaciones y efectos adversos a la gestión de los riesgos de la asistencia sanitaria. Valenc" "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Aranaz JM." ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Reporting of adverse events." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Leape LL." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMNEJMhpr011493" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2002" "volumen" => "347" "paginaInicial" => "1633" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12432059" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Ambulatory care visits for treating adverse drug events in the United States, 1995-2001." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Zhan C" 1 => "Arispe I" 2 => "Kelley E" 3 => "Ding T" 4 => "Burt C" 5 => "Shinogle J" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Quality Patient Safety" "fecha" => "2005" "volumen" => "31" "paginaInicial" => "372" "paginaFinal" => "8" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Critical incident reporting in UK intensive care units: a postal survey." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Thomas AN" 1 => "Pilkington CE" 2 => "Greer R." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Eval Clin Pract" "fecha" => "2003" "volumen" => "9" "paginaInicial" => "59" "paginaFinal" => "68" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12558703" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "The world health report 2000. Health systems: improving performance. Geneva: WHO, 2000." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The world health report 2000. Health systems: improving performance. Geneva: WHO, 2000." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "World Health Organization." ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The public versus the World Health Organization on health system performance." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Blendon RJ" 1 => "Kim M" 2 => "Benson JM." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Health Aff (Millwood)" "fecha" => "2001" "volumen" => "20" "paginaInicial" => "10" "paginaFinal" => "20" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "A critique of the World Health Organization's evaluation of health system performance." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Richardson J" 1 => "Wildman J" 2 => "Robertson IK." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hec.761" "Revista" => array:6 [ "tituloSerie" => "Health Economics" "fecha" => "2003" "volumen" => "12" "paginaInicial" => "355" "paginaFinal" => "66" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12720253" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Hussy PS" 1 => "Anderson GF" 2 => "Osborn R" 3 => "Feek C" 4 => "McLaughlin V" 5 => "Millar J" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "How does the quality of care compare in five countries? Health Aff (Millwood)" "fecha" => "2004" "volumen" => "23" "paginaInicial" => "89" "paginaFinal" => "99" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Walshe K." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "International comparisons of the quality of health care:what do they tell us? Qual Saf Health Care" "fecha" => "2003" "volumen" => "12" "paginaInicial" => "4" "paginaFinal" => "5" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Marshall MN" 1 => "Shekelle EA" 2 => "McGlynn EA" 3 => "Campbell S" 4 => "Brook RH" 5 => "Rolond MO." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Can health care quality indicators be transferred between countries? Qual Saf Health Care" "fecha" => "2003" "volumen" => "12" "paginaInicial" => "8" "paginaFinal" => "12" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Measuring the health of nations: analysis of mortality amenable to health care." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Nolte E" 1 => "McKe.e" 2 => "M." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.327.7424.1129" "Revista" => array:6 [ "tituloSerie" => "BMJ" "fecha" => "2003" "volumen" => "327" "paginaInicial" => "1129" "paginaFinal" => "33" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14615335" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Perspective: there is no perfect health system." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "McGlynn E." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Health Aff (Millwood)" "fecha" => "2004" "volumen" => "23" "paginaInicial" => "100" "paginaFinal" => "2" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "The current state of performance measurement in health care. Int J Qual Health Care. 2004;16 Suppl. 1:15-9." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The current state of performance measurement in health care. Int J Qual Health Care. 2004;16 Suppl. 1:15-9." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Loeb JM." ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "Healthcare Research and Quality Act 1999. Statutes at large. Vol. 113, Sec 1653 (Public Law 106-129; Section 913[b] 2) 1999." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Healthcare Research and Quality Act 1999. Statutes at large. Vol. 113, Sec 1653 (Public Law 106-129; Section 913[b] 2) 1999." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "US Congress." ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "The US National Healthcare Quality and Disparities Report. (Rockville, MD: The Agency for Healthcare Research and Quality) 2006." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The US National Healthcare Quality and Disparities Report. (Rockville, MD: The Agency for Healthcare Research and Quality) 2006." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "US Department of Health and Human Services." ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "Estudio de prevalencia de las infecciones nosocomiales en España, 1990-2006: 17 años. SEMPSPH, 2007. Available from: http://www.mpsp.org/mpsp/Epine07/Epine_2007.htm" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Estudio de prevalencia de las infecciones nosocomiales en España, 1990-2006: 17 años. SEMPSPH, 2007. 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Información de la revista
Vol. 22. Núm. 6.
Páginas 317-326 (noviembre 2007)
Vol. 22. Núm. 6.
Páginas 317-326 (noviembre 2007)
Acceso a texto completo
Safety Data for Safer Care: The Importance of International Consensus and Action
Safety Data for Safer Care: The Importance of International Consensus and Action
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Objetivo: El interés en la medida y en la evaluación de la calidad ha crecido considerablemente a través de las últimas 2 décadas debido a diversos factores, como el reconocimiento de la gran variabilidad existente en la práctica clínica, la mayor disponibilidad de evidencia de eficacia probada y la creciente preocupación sobre el costo y la calidad del cuidado de la salud. En particular, el interés ha crecido en asegurar que el cuidado de la salud sea seguro, sobre todo desde que en 2001 el Institute of Medicine (IOM) incluyera la seguridad como una más de las dimensiones de la calidad. Este interés en la seguridad no está relacionado con barreras internacionales o con las particularidades de "mayor desarrollo" o "menor desarrollo" de un país. Iniciativas internacionales del más alto nivel gubernamental, como las de la Organización para la Cooperación Económica y del Desarrollo (OCDE), el Proyecto de Indicadores de Calidad en Salud (HQIP) y su grupo de trabajo en Seguridad del Paciente o la de la Alianza mundial por la Seguridad del Paciente de la OMS, resaltan la necesidad de un convenio internacional para lograr un mayor aprendizaje sobre la seguridad del paciente. Sin embargo, poco se ha estado haciendo para mejorar la disponibilidad y la comparabilidad de los datos/indicadores acerca de la seguridad del paciente dentro y entre los países. Material y método: En este artículo, describimos el trabajo realizado por cuerpos nacionales como la Agencia para la Investigación y la Calidad de la Asistencia Sanitaria (AHRQ) de Estados Unidos y por organizaciones internacionales como la OCDE y la Alianza Mundial (OMS) para mejorar los datos de seguridad en la búsqueda de proveer un cuidado más seguro, a la vez que contrastamos con la información existente en España sobre esta misma cuestión. Resultados: La propuesta de la OCDE pretende identificar las medidas apropiadas para favorecer comparaciones en el ámbito internacional, aunque una serie de dificultades (disponibilidad de datos, aspectos éticos, organización de los sistemas) hace que el número de indicadores sugeridos se haya visto reducido. Los indicadores que propone la AHRQ, basándose en varias fuentes de información sólidas, ofrecen una visión más rica respecto a la seguridad del paciente en el ámbito nacional. En España, existen iniciativas para comparación internacional mediante los indicadores propuestos por la OCDE e, internamente, usando los propuestos por la AHRQ, basándose en el CMBD. Conclusiones: El desarrollo de los sistemas de datos sobre seguridad del paciente, tanto en el ámbito nacional como en el internacional, tiene aún un largo camino por recorrer. Un aspecto importante a considerar es la necesidad de involucrar a los pacientes y sus asociaciones en la recogida y registro de datos sobre seguridad del paciente.
Palabras clave:
Seguridad de pacientes
Indicadores de seguridad
Calidad asistencial
Objective: Interest in comparative quality measurement and evaluation has grown considerably over the past two decades due to several factors, such as recognition of widespread variation in clinical practice, the increased availability of evidence on medical effectiveness, and increasing concern about the cost and quality of healthcare. Interest in ensuring that healthcare is safe has grown, particularly since 2001 when the Institute of Medicine (IOM) included patient safety as another quality dimension. This interest in safety is not limited by international borders or by classifications of "more developed" or "less developed" countries. International initiatives at the highest levels of government such as the Organization for Economic Cooperation and Development's (OECD) Health Care Quality Indicators Project and its Patient Safety Working Group, as well as the World Alliance for Patient Safety, highlight the need for international agreement to increase learning on patient safety. However, little is being done to improve the availability and comparability of data/indicators on patient safety within and between countries. Material and method: In this paper, we describe the work being done by national bodies such as the US Agency for Healthcare Research and Quality (AHRQ), and international organizations such as the OECD and the World Alliance (WHO) to improve safety data with a view to providing safer care. At the same time, we compare this with information existing in Spain on this same question. Results: The proposal by the OECD attempts to identify suitable measurements to enable comparisons at international level, although several difficulties (availability of data, ethical aspects, organization of the systems) mean that the number of indicators has been reduced. The indicators proposed by the AHRQ, based on several solid information sources, offer a much clearer vision as regards patient safety at national level. In Spain, there are initiatives for international comparisons using the indicators proposed by the OECD and, at national level, using the proposals by AHRQ, based on the MBDS (minimum basic data set). Conclusions: The development of patient safety data systems, both at national and international level, still has a long way to go. One important aspect to consider, is the need to involve patients and their associations in the collection and recording of data on patient safety.
Keywords:
Patient safety
Safety indicators
Quality care
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Bibliografía
[1]
Accroître la sécurité du système. Une stratégie integrée pour améliorer la sécurité des patients dans le système de santé Canadian (acceded 04/10/2007). National Steering Committee on Patient Safety. Available from: http://www.rcpsc.medical.org/french/publications/
[2]
Experiencias nacionales e internacionales en la gestión de riesgos: pasado, presente y futuro. In: Aranaz JM, Vitaller J and Grupo de Estudio del Proyecto IDEA. Identificación de efectos adversos. De las complicaciones y efectos adversos a la gestión de los riesgos de la asistencia sanitaria. Valenc
[3]
Leape LL..
Reporting of adverse events..
N Engl J Med, 347 (2002), pp. 1633-8
[4]
Zhan C, Arispe I, Kelley E, Ding T, Burt C, Shinogle J, et al..
Ambulatory care visits for treating adverse drug events in the United States, 1995-2001..
J Quality Patient Safety, 31 (2005), pp. 372-8
[5]
Thomas AN, Pilkington CE, Greer R..
Critical incident reporting in UK intensive care units: a postal survey..
J Eval Clin Pract, 9 (2003), pp. 59-68
[6]
The world health report 2000. Health systems: improving performance. Geneva: WHO, 2000.
[7]
Blendon RJ, Kim M, Benson JM..
The public versus the World Health Organization on health system performance..
Health Aff (Millwood), 20 (2001), pp. 10-20
[8]
Richardson J, Wildman J, Robertson IK..
A critique of the World Health Organization's evaluation of health system performance..
Health Economics, 12 (2003), pp. 355-66
[9]
Hussy PS, Anderson GF, Osborn R, Feek C, McLaughlin V, Millar J, et al..
How does the quality of care compare in five countries? Health Aff (Millwood), 23 (2004), pp. 89-99
[10]
Walshe K..
International comparisons of the quality of health care:what do they tell us? Qual Saf Health Care, 12 (2003), pp. 4-5
[11]
Marshall MN, Shekelle EA, McGlynn EA, Campbell S, Brook RH, Rolond MO..
Can health care quality indicators be transferred between countries? Qual Saf Health Care, 12 (2003), pp. 8-12
[12]
Nolte E, McKe.e, M..
Measuring the health of nations: analysis of mortality amenable to health care..
BMJ, 327 (2003), pp. 1129-33
[13]
McGlynn E..
Perspective: there is no perfect health system..
Health Aff (Millwood), 23 (2004), pp. 100-2
[14]
The current state of performance measurement in health care. Int J Qual Health Care. 2004;16 Suppl. 1:15-9.
[15]
Healthcare Research and Quality Act 1999. Statutes at large. Vol. 113, Sec 1653 (Public Law 106-129; Section 913[b] 2) 1999.
[16]
The US National Healthcare Quality and Disparities Report. (Rockville, MD: The Agency for Healthcare Research and Quality) 2006.
[17]
Estudio de prevalencia de las infecciones nosocomiales en España, 1990-2006: 17 años. SEMPSPH, 2007. Available from: http://www.mpsp.org/mpsp/Epine07/Epine_2007.htm
[18]
Health Care Quality Indicators Project Initial Report. March 10, 2006.
[19]
OECD Health Care Quality Indicators Project Initial Indicators Report. OECD Health Working Paper no. 22. (Paris: OECD). 2006. Available from: www.oecd.org/health/hcqi.
[20]
OECD Health Care Quality Indicators Project OECD 2006 data collection update report on indicators. Health Working Paper no. 27. (Paris: OECD). 2007. Avaiulable from: www.oecd.org/health/hcqi
[21]
Selecting indicators for patient safety at the health systems level in OECD countries. OECD Technical Working Paper no. 18. October 2004. Available from: www.oecd.org/health/hcqi
[22]
Selecting indicators for the quality of mental health care at the health systems level in OECD countries. OECD Technical Working Paper no. 17. October 2004. Available from: www.oecd.org/health/hcqi