Biomedical subjects

Elizabeth Restrepo

Publications and source records attributed to Elizabeth Restrepo.

4 recordsLinked to original sources

PubMedDate not supplied

Birth certificate methods in five hospitals.

This study evaluated the methods of data collection of birth certificate information by five high-delivery hospitals in northern Texas. Research purposes were to identify sources and methods of birth certificate data collection and identify the most-reliable methods. This descriptive study involved interviews of each hospital's data collectors and review of 1999 Texas birth certificate data. Medical record clerks, whose training varied, but usually consisted of orientation by another medical record clerk, collected birth certificate data within 24 hours of birth. There was no standard method for training, nor was there a minimum level of education required. In four of the five hospitals studied, a birth certificate clerk collected most of the information with limited input from other medical sources. The information obtained on birth certificates therefore varied according to the collector and the priority placed upon the accuracy of information. Birth certificate data contain questionable reliability, which undermines data use in research, funding, and policy decisions.

Bias↗

PubMedDate not supplied

Sociodemographic factors associated with weekend birth and increased risk of neonatal mortality.

OBJECTIVE: To learn whether weekend risk of neonatal mortality is related to selected sociodemographic factors. DESIGN: A retrospective cohort design. Logistic regression was used to obtain odds ratios, and analysis of variance and chi-square to identify differences in values and incidence of key variables. SAMPLES: The data were derived from matched Texas birth and infant death certificates from 1999 through 2001. MAIN OUTCOME MEASURES: A subset of deaths up to 28 days of life attributable to conditions originating in the perinatal period. These deaths were called neonatal mortality-p. RESULTS: Women who were White, married, had Medicaid assistance, and had private prenatal care were less likely to deliver on weekends. Odds of neonatal mortality-p increased 36.5% when a birth took place on the weekend. The weekend crude odds of neonatal mortality-p increased for all racial/ethnic groups, but the differences were not statistically significant. CONCLUSIONS: The likelihood of delivering on the weekend increases with certain sociodemographic factors. This fact is important because the risk of neonatal mortality is higher among weekend births.

Adult↗

PubMedDate not supplied

Weekend birth and higher neonatal mortality: a problem of patient acuity or quality of care?

OBJECTIVE: To address the differences in neonatal mortality among births to teenage mothers on weekdays and weekends. DESIGN: A retrospective descriptive design. Rates of neonatal mortality linked to maternal risk factors, low birth weight, gestational age, day of the week of the birth, and ethnicity/race were examined. PATIENTS/PARTICIPANTS: The population consisted of all recorded births to teenage mothers (< 20 years of age) in Texas in 1999 and 2000 (N = 111,749). These births were linked to death certificates for a subset of neonatal deaths within the same time period (n = 397). MAIN OUTCOME MEASURES: The outcome of interest was any death attributed to conditions originating in the perinatal period and recorded as such on the infant death certificate. RESULTS: Neonatal mortality was higher among the births on weekends than those during the week. Maternal risks and patient acuity levels of mothers and babies were not consistently higher on weekends. However, when risk factors were present, weekend births were more dangerous for Hispanics than for other ethnic or racial groups. CONCLUSIONS: Differences in patient acuity did not satisfactorily explain higher neonatal mortality rates on weekends. Thus, quality of care indicators such as lower hospital staffing and reduced availability of services on weekends may be critical sources of unnecessary neonatal deaths.

Adolescent↗

PubMedDate not supplied

Cautious use of administrative data for decubitus ulcer outcome reporting.

The purpose of this study is to demonstrate that caution should be exercised when using administrative data, exclusively, to report quality and safety outcomes. Investigators identified hospital-acquired decubitus ulcers using Agency for Health-care Research and Quality (AHRQ) patient safety indicator definitions. As validation of this method, investigators abstracted 123 medical charts of patients identified through AHRQ methodology as having hospital-acquired decubitus ulcers. Abstraction of these cases produced a change in rate from 23.3 decubitus ulcers per 1000 patients, derived through administrative data, to a true rate of 7.9 decubitus ulcers per 1000 patients, a 66% reduction. Investigators found 2 additional flaws (1 internal and 1 methodological) that further decreased the decubitus ulcer rate to 6.14 per 1000, a 74% variance. The results of this study suggest that administrative data, when used alone, are not sufficient in measuring the true rate of hospital-acquired decubitus ulcers.

Cross Infection↗