Quality of care in adult heart surgery

proposal for a self-assessment approach based on a French multicenter study

F. Roques, F. Gabrielle, P. Michel, C. De Vincentiis, M. David, E. Baudet

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

A prospective study was carried out from January to April 1993 in 42centers to assess the quality of care in adult heart surgery in France. Onehundred eight parameters were collected (i.e., risk factors, surgery, postoperative course) for 7181 patients. Eight simple, objective factorswere selected using a multivariate analysis. Point weighting was assignedto each factor. A simple cumulative score was thereby established toclassify patients within four incremental risk groups (respectivedistribution of patients and mortality were 38.6%, 26.5%, 21.3%, 13.5% and2%, 3.9%, 6.1%, 21.4%). This score was highly predictive for mortality andsevere morbidity. Objectivity and independence of the observer, coupledwith a reliable score, are needed for meaningful assessment of the qualityof care. Administrative supervision and/or comparison of raw center resultstherefore remain controversial. A national data base was developed as apart of this study, that includes anonymous information from two-thirds ofall cardiac surgery cases. Nation-wide results for France allow each centerfreely to assess its results. This self-assessment approach is, in ourview, the most accurate way of quality of care assessment. A pan- Europeansystem using a similar approach should be developed.

Original languageEnglish
Pages (from-to)433-439
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume9
Issue number8
DOIs
Publication statusPublished - 1995

Fingerprint

Quality of Health Care
Thoracic Surgery
Multicenter Studies
France
Mortality
Multivariate Analysis
Databases
Prospective Studies
Morbidity
Self-Assessment

Keywords

  • Open heart surgery
  • Operative mortality
  • Quality of care
  • Risk assessment
  • Risk stratification

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Quality of care in adult heart surgery : proposal for a self-assessment approach based on a French multicenter study. / Roques, F.; Gabrielle, F.; Michel, P.; De Vincentiis, C.; David, M.; Baudet, E.

In: European Journal of Cardio-thoracic Surgery, Vol. 9, No. 8, 1995, p. 433-439.

Research output: Contribution to journalArticle

Roques, F. ; Gabrielle, F. ; Michel, P. ; De Vincentiis, C. ; David, M. ; Baudet, E. / Quality of care in adult heart surgery : proposal for a self-assessment approach based on a French multicenter study. In: European Journal of Cardio-thoracic Surgery. 1995 ; Vol. 9, No. 8. pp. 433-439.
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