Comparing Results of Concurrent and Retrospective Designs in a Hospital Utilization Review

Hospital utilization reviews are performed on the basis of lists of explicit criteria, such as the Appropriateness Evaluation Protocol, both concurrently and retrospectively, in an increasing number of settings as part of efforts to improve the performance of hospitals and to reduce health care costs. Retrospective data collection has advantages in terms of expenses and ease of sampling, but relies on the quality of medical records. We report on a comparison between concurrent and retrospective data collection performed simultaneously and independently by two reviewers on the same hospital stays in the regional St-Loup Hospital. Results suggest that retrospective data collection produces higher rates of inappropriate hospital utilization, due to a limited number of criteria that are recorded concurrently, but are not found in the retrospective reading of medical records. These results should encourage a further investigation of the comparability between concurrent and retrospective designs in other settings. © 1997 Elsevier Science Ltd. All rights reserve

Prevalence of tail lesions in Swiss finishing pigs.

INTRODUCTION Tail biting and lesions are common problems in modern pig production. In 2008 tail docking to prevent tail biting was banned in Switzerland. Since then pigs have been raised with intact tails. This study aimed to assess the current prevalence of tail lesions at Swiss abattoirs and comparing abattoir data with farm-specific data regarding potential risk factors for tail lesions. Data collection was performed in repetitive cycles of two weeks at four abattoirs during all consecutive seasons of one year. Gender, tail length and the tail tip condition were evaluated among other parameters. During 32 weeks in total, 195 704 pigs from 6112 batches from 2510 herds were evaluated. Overall, 63,2 % of the animals included in the analysis were slaughtered with a complete tail (lowest tail length score [TLS]), whereas 36,8 % showed a partial or total loss of the tail. The condition of the tail tip (tail tip condition score [TTCS]) was judged as being intact in 63,0 %, as a healed lesion in 23,7 %, an acute lesion in 1,3 % and a chronic lesion in 12,0 % of all cases. Male animals had significantly higher values for TLS and TTCS than female animals (P ≤ 0,05). TLS values were significantly higher in winter than in spring and summer (P < 0,001). TTCS values were significantly higher in fall than in spring and summer. TLS and TTCS values differed significantly (P < 0,001) between the four abattoirs. Only few significant correlations were found between values of TLS and TTCS and farm-specific data. Recording tail lesions at abattoirs is an accurate method to investigate the prevalence of tail lesions in fattening pigs. However, to monitor animal welfare on herd level, this method is very labor intensive. Moreover, data on tail lesions collected at the abattoir cannot replace veterinary on-farm examination for risk factor identification