• 作者：J.C. Vald&#233 ; s^a ; ^{carles.valdes@sanitatintegral.org} ; M. Videla^a ; M. Lafuente^a ; E. Henere^a ; A. Poal-Manresa^a ; P. Madrid^b ; A. Benet^c ; S. Videla^d
• 关键词：Asistencia mé ; dica ; Auditorí ; as clí ; nicas ; Artroplastia total de cadera
• 刊名：Revista de Calidad Asistencial
• 出版年：2011
• 期刊代码：pca305_1134282X
• 类别：med
• 出版时间：March-April 2011
• 卷：26
• 期：2
• 页码：83-89
• 文件大小：144 K

Background

Clinical audits are critical and systematic quality analysis of medical care. Total hip arthroplasty (THA) is a routine practice and cost-effective, although there is little information on the quality of care of it.

Objective

To evaluate the impact of a clinical audit cycle in the quality of care in the primary THA procedures for non-traumatic cause.

Patients and methods

A series of two audits (first audit in 2005 and second one in 2007) were performed. Patients of both sexes with non-traumatic primary THA and with a follow-up of 6 months were included. Time (days) in hospital stay and the rate (percentage) of readmissions were used as indicators of management; and as indicators of clinical practice: the index (percentage) of dislocation and the rate (percentage) of infection. Both audits were compared with respect to these indicators.

Results

A total of 160 patients (79 and 81, first and second audit respectively) were analysed. Management indicators: median (range) of hospital stay was 8 (7-78) and 7 (6-16), p < 0.001, and the percentage of readmissions 5%(4/79) and 0 (0/81), p = 0.057. Indicators of clinical practice: the rate of dislocation was 8%(6/79) and 0 (0/81), p = 0.013, and the rate of infection 1%(1/79) and 1%(1/81), p = 1. A multivariate analysis did not find other factors related to these indicators.

Conclusions

The implementation of a clinical audit cycle has improved the quality of care of primary THA procedures for non-traumatic cause.