Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

More documents

Recommendations

Info

36 Maternal Intensive Care in Belgium KCE Reports 94 These two databases (IMA & MKG/RCM) were merged to obtain one database that combines all available information for each patient. More information about the merging procedure is described in the next chapter and in the annexes. 4.2.3 Database construction Selection criteria and coding rules have been devised in order to maximize the merge rate of the two original databases. Data selection was performed in four steps: • Step 1: Selection of the maternity stays First, we selected in both databases all patients who were admitted to a maternity ward between 01/01/2003 and 31/12/2004 on the basis of the code of the hospital department (codes 260 and 26 for maternity ward). In the MKG/RCM data, only in-patient stays are selected; day care is excluded from the merger for technical reasons. We structured the received MKG/RCM stays in three separate datasets based on the age of the patient: one containing the data of the mothers, one with the neonates (age=0) and one with the double records 21 . • Step 2: Selection of the deliveries or other pregnancy outcomes In order to study the care given to pregnant women, we selected from the IMA/AIM data only patients who were billed for a vaginal delivery, a Caesarean section or a miscarriage (admitted to hospital or in ambulatory care). The above-mentioned care was identified in the bills through detailed nomenclature codes 22 . • Step 3 : Selection of the newborns The third step is the addition of the IMA/AIM data on all newborns. Neonates admitted to maternity wards are automatically included in the database. We additionally selected neonates who were admitted to a neonatal department N* or neonatal intensive care department (NIC) – codes of departments 190 or 19 and 270 or 27. • Step 4: Selection of all members of the social security scheme The fourth step is the selection of all social security beneficiaries, as this subpopulation can be followed up longitudinally in the IMA/AIM data. This selection is made during the merging procedure between MKG/RCM data (all patients) and IMA/AIM data (all social security beneficiaries). 4.2.4 Linkage of the IMA/AIM data with the MKG/RCM data In order to study the care of these patients and their trajectories in a longitudinal way, the MKG/RCM data are linked with the IMA/AIM data. Before starting, an anonymous identity (ID)-number has been added to the MKG/RCM data in order to create a link with the IMA/AIM data. This ID-number is based on the so-called national register number, a unique identification number assigned to each Belgian citizen. From the IMA/AIM population data, numerous variables were used as quality checks for the merging procedure: identification of the beneficiary, sex, and INS code. After data selection and data cleansing 23 , 195.110 stays in 2003 and 202.500 stays in 2004 were ready to be merged in the MKG/RCM data. The merging procedure is based primarily on the mother's identity number, the hospital number and the admission and discharge date. Only the stays containing all four elements are taken into account for the merger. The merging procedure was applied to the three created datasets: mothers, babies and double records 24 . 21 see appendix 22 see appendix 23 see appendix 24 see below : 1.2.2.3. step1
KCE Reports 94 Maternal Intensive Care in Belgium 37 When the merge procedure 25 was carried out, 91.2% of all stays in 2003 and 92.4 % of all stays in 2004 were eventually merged with the IMA/AIM data. The stays that could not be merged are subjected to a separate analysis (see annex). Table 8 summarizes the results of the merging procedure. Table 8: Result of the merge between both databases 2003 2004 RCM stays to link 195,110 202,500 Linked RCM stays with IMA stays 178,514 186,265 % linked stays 91.2% 92.4% Unlinked RCM stays Difference with source data 16,742 16,421 Delta > 0 because of the linking of dubbles 146 186 4.2.5 Study population After the merging procedure, all possible inconsistencies were excluded or adequately corrected. Data of some neonates were left aside because of a missing baby ID number 26 in the IMA dataset (the linkage was done on the ID of the mothers). Eventually, 130.584 newborn stays have been merged this way. Among the unmerged babies, 68% do not have the MKG/RCM number of the mother. Finally, the databases available for analysis contained: • 198.502 patients with at least one maternity stay in 2003 or 2004, totalling 243.947 merged stays; • 197.419 neonates born in 2003 or 2004, accounting for 240.711 hospital stays. In addition, 11.035 stays of ‘mother’ and 21.752 stays of ‘newborns’ remained unmerged because there was no IMA/AIM identification or the date of the in-patient stay did not correspond in the two databases. These stays are analyzed separately (see annex). Table 9: Overview of denominators used in the report Pregnant women Total 97,648 Mat. With MIC - services Mat. without MICservices In-patient stays 113,845 32,099 81,746 Ante-partum stays 14,889 4,201 10,688 Stay of Delivery = nb of pregnancies 97,718 27,318 70,400 Mode of delivery Vaginal deliveries 78,694 21,380 57,314 C-sections 18,164 5,598 12,566 Total 96,858 26,978 69,880 Embryotomies 4 0 4 Miscarriages 856 340 516 Postpartum stays 1,238 580 658 Transfers 1,073 862 211 Intra-uterin transfers 660 510 150 Postpartum transfers 413 352 61 25 see appendix 26 see appendix
Page 1 and 2: Soins maternels intensifs (Maternal
Page 3 and 4: Soins maternels intensifs (Maternal
Page 5 and 6: KCE Reports 94B Soins Maternels Int
Page 11 and 12: KCE Reports 94 Maternal Intensive C
Page 45: KCE Reports 94 Maternal Intensive C
Page 53 and 54: Number of women KCE Reports 94 Mate
Page 55 and 56: 45,00% 40,00% 35,00% 30,00% 25,00%
Page 67 and 68: Status KCE Reports 94 Maternal Inte
Page 91 and 92: Percentage intermediate care women
Page 97 and 98:
KCE Reports 94 Maternal Intensive C
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
kCE Reports 94 Maternal Intensive C
Page 117 and 118:
Fowler, S.J. (2005) kCE Reports 94
Page 119 and 120:
Schatz et al ( 15 bis kCE Reports 9
Page 121 and 122:
Zeeman, G., Wendel, G. & Cunningham
Page 123 and 124:
Ryan, M., Hamiltin, V., Bowen, M. &
Page 125 and 126:
Baskett, T. & Sternadel, J. (1998)
Page 127 and 128:
Lapinsky, S., Kruczynski, K., Seawa
Page 129 and 130:
Cohen, J., Singer, P., Kogan, A., H
Page 131 and 132:
Quah, T., Chiu, J., Tan, K., Yeo, S
Page 133 and 134:
Gilbert, T., Smulian, J., Martin, A
Page 135 and 136:
Mirghani, H., Hamed, M. & Weerasing
Page 137 and 138:
Selo-Ojeme, D., Omosaiye, M., Batta
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167:
Page 170 and 171:
Dépôt légal : D/2008/10.273/78
Page 172 and 173:
35. Etude relative aux coûts poten
show all

Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?