Facilitating Cross-National Comparisons of Indicators for Patient ...

DELSA/ELSA/WD/HTP(2008)1SUMMARYThis publication was prepared to support the overall work of the OECD Health Care Quality IndicatorsProject in developing a set of indicators that can be used to raise questions for investigation concerning thequality of care across countries.It provides a manual to facilitate cross national comparisons of indicators for patient safety through theprovision of detailed practical advice on calculating each indicator in a selected set of Patient SafetyIndicators (PSI) utilising national hospital administrative databases.The selected indicators are:AreaHospital-acquired infectionsOperative and post-operativecomplicationsSentinel eventsObstetricsIndicator nameInfection due to medical careDecubitus ulcerComplications of anaesthesiaPostoperative hip fracturePostoperative pulmonary embolism (PE) or deep vein thrombosis(DVT)Postoperative sepsisTechnical difficulty with procedurePostoperative respiratory failureIatrogenic pneumothoraxTransfusion reactionForeign body left in during procedureBirth trauma - injury to neonateObstetric trauma – vaginal delivery with instrumentObstetric trauma – vaginal delivery without instrumentObstetric trauma - caesarean sectionFor each of these indicators, the manual provides:• Generic coding and calculation instructions related to national hospital administrative databases,• Cross walk from ICD 9 to ICD 10 codes for each indicator,• Detailed definitions for calculation of indicators, and• Flow charts for visualising the calculation process.The manual was originally designed to support the calculation of patient safety indicators in a group ofcountries volunteering to participate in the validation of the methodology. However it is anticipated thatthe material presented will also be of interest to a wider audience, including researchers and expertsinterested in the technical background and construction of the Patient Safety Indicators and other countrieslooking to develop internationally comparable health care quality indicators.4