Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/91801
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Type: | Journal article |
Title: | Geographic variation of Failure-to-Rescue in public acute hospitals in New South Wales, Australia |
Author: | Assareh, H. Ou, L. Chen, J. Hillman, K. Flabouris, A. Hollis, S. |
Citation: | PLoS One, 2014; 9(10):e109807-1-e109807-8 |
Publisher: | Public Library of Science |
Issue Date: | 2014 |
ISSN: | 1932-6203 1932-6203 |
Editor: | Rosenberg, E.S. |
Statement of Responsibility: | Hassan Assareh, Lixin Ou, Jack Chen, Kenneth Hillman, Arthas Flabouris, Stephanie J. Hollis |
Abstract: | Despite the wide acceptance of Failure-to-Rescue (FTR) as a patient safety indicator (defined as the deaths among surgical patients with treatable complications), no study has explored the geographic variation of FTR in a large health jurisdiction. Our study aimed to explore the spatiotemporal variations of FTR rates across New South Wales (NSW), Australia. We conducted a population-based study using all admitted surgical patients in public acute hospitals during 2002-2009 in NSW, Australia. We developed a spatiotemporal Poisson model using Integrated Nested Laplace Approximation (INLA) methods in a Bayesian framework to obtain area-specific adjusted relative risk. Local Government Area (LGA) was chosen as the areal unit. LGA-aggregated covariates included age, gender, socio-economic and remoteness index scores, distance between patient residential postcode and the treating hospital, and a quadratic time trend. We studied 4,285,494 elective surgical admissions in 82 acute public hospitals over eight years in NSW. Around 14% of patients who developed at least one of the six FTR-related complications (58,590) died during hospitalization. Of 153 LGAs, patients who lived in 31 LGAs, accommodating 48% of NSW patients at risk, were exposed to an excessive adjusted FTR risk (10% to 50%) compared to the state-average. They were mostly located in state's centre and western Sydney. Thirty LGAs with a lower adjusted FTR risk (10% to 30%), accommodating 8% of patients at risk, were mostly found in the southern parts of NSW and Sydney east and south. There were significant spatiotemporal variations of FTR rates across NSW over an eight-year span. Areas identified with significantly high and low FTR risks provide potential opportunities for policy-makers, clinicians and researchers to learn from the success or failure of adopting the best care for surgical patients and build a self-learning organisation and health system. |
Keywords: | Humans Postoperative Complications Mortality Risk Geography Time Factors Local Government Hospitals, Public New South Wales |
Rights: | © 2014 Assareh et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
DOI: | 10.1371/journal.pone.0109807 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1009916 http://purl.org/au-research/grants/nhmrc/1020660 |
Published version: | http://dx.doi.org/10.1371/journal.pone.0109807 |
Appears in Collections: | Aurora harvest 2 Medicine publications |
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hdl_91801.pdf | Published version | 596.61 kB | Adobe PDF | View/Open |
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