18 research outputs found

    Ratio of the expected early neonatal mortality rate compared to national average by HSA, 2004–2006.

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    <p>Ratio of the expected early neonatal mortality rate compared to national average by HSA, 2004–2006.</p

    Expected and Observed ENND rate 1996–2006.

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    <p>Expected and Observed ENND rate 1996–2006.</p

    First-stage GA-BW adjustment model for Early Neonatal Deaths among US births (1996–2006).

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    <p>First-stage GA-BW adjustment model for Early Neonatal Deaths among US births (1996–2006).</p

    Ratio of the GA-BW adjusted early neonatal mortality rate compared to national average by HSA, 2004–2006.

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    <p>Ratio of the GA-BW adjusted early neonatal mortality rate compared to national average by HSA, 2004–2006.</p

    Variance in GA-BW adjusted ENN mortality explained by HSA covariates (2004–2006).

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    <p>Variance in GA-BW adjusted ENN mortality explained by HSA covariates (2004–2006).</p

    Health Service Area (HSA) covariates.

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    *<p>Preterm was defined as a birth before 34 weeks gestation.</p

    Modelling risk-adjusted variation in length of stay among Australian and New Zealand ICUs

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    <div><p>Purpose</p><p>Comparisons between institutions of intensive care unit (ICU) length of stay (LOS) are significantly confounded by individual patient characteristics, and currently there is a paucity of methods available to calculate risk-adjusted metrics.</p><p>Methods</p><p>We extracted de-identified data from the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database for admissions between January 1 2011 and December 31 2015. We used a mixed-effects log-normal regression model to predict LOS using patient and admission characteristics. We calculated a risk-adjusted LOS ratio (RALOSR) by dividing the geometric mean observed LOS by the exponent of the expected Ln-LOS for each site and year. The RALOSR is scaled such that values <1 indicate a LOS shorter than expected, while values >1 indicate a LOS longer than expected. Secondary mixed effects regression modelling was used to assess the stability of the estimate in units over time.</p><p>Results</p><p>During the study there were a total of 662,525 admissions to 168 units (median annual admissions = 767, IQR:426–1121). The mean observed LOS was 3.21 days (median = 1.79 IQR = 0.92–3.52) over the entire period, and declined on average 1.97 hours per year (95%CI:1.76–2.18) from 2011 to 2015. The RALOSR varied considerably between units, ranging from 0.35 to 2.34 indicating large differences after accounting for case-mix.</p><p>Conclusions</p><p>There are large disparities in risk-adjusted LOS among Australian and New Zealand ICUs which may reflect differences in resource utilization.</p></div
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