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Hospital Days During the Last Six Months of Life

Basic facts

Stage of development

Designed

Potential or current usage

This measure identifies the number of days spent in hospital during the last six months of life.

Brief overview of the measure

General description

This measure addresses the management of death, covering the interface between primary and secondary care.

Rationale for selection

From the point of view of patient experience and system efficiency, it is preferred that death be managed outside of the hospital environment. Improvements in the management of death should be reflected in shorter average in-hospital care.

Type of measure

Outcomes

Domain(s) of quality

Efficiency, People-centred

Application and interpretation of the measure

Stated intent of the measure

To measure the number in days in hospital during the last six months of life.

Caveats - Considerations

The purpose of this is to identify the strengths and limitations of the measure, and to provide parameters around the ideal use of the measure according to its strengths and limitations. These strengths and limitations need to be considered by all users of the measure. This is to ensure both appropriate use of the measure and that the limitations of the measure are taken into account when interpreting results obtained on the measure.

Calculation of the measure

Output of calculation

The average publicly funded, personal healthcare, inpatient bed days in any six month period for each death.

Numerator description

Hospital days during last six months of life.

Numerator exclusions

Disability support services, Mental Health, Health of Older People, Palliative care services

Denominator description

Patients who have died

Denominator exclusions

None

Time period

6 months

Data source

Merged NMDS and Mortality collections

Key issues and challenges for data management

Analytical Services in MoH is confident that fact of death is relatively quickly loaded into the Mortality database.

Appraisal of the measure

Availability of evidence to support application of the measure

The measure has been developed or endorsed by an organisation seeking to improve clinical effectiveness as part of a continuous quality improvement cycle (at an international, national, regional or local level).

Evidence of feasibility and reliability of implementation

Reliability - The measure has been demonstrated to be reliable (i.e. free from random error)., Interpretation - The measure allows unambiguous interpretation of better or worse performance., Cultural values - The measure is able to reflect cultural values., Data extraction - Data collection specifications for the measure are well defined., Data sources - Required data elements for the measure can be obtained from existing data sources., Availability of data - Required data elements for the measure can be gathered during routine practice activities, IT software - Existing IT software is sufficient for data collection., Adaptability - Measure is able to be adapted for use in multiple care settings, Validity - The measure has been demonstrated to be valid (i.e. it measures what it purports to).

Other items

Owner detail

Reference number

904

Date of entry to library

2012-05-31 14:45:00

Owner (Organisation name)

Health Quality and Safety Commission, Indicators project team

Owner (Email contact)

richard.hamblin@hqsc.govt.nz

Creator (Organisation name)

Institute for Healthcare Improvement

Creator (Email contact)

richard.hamblin@hqsc.govt.nz