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The danger of non-exhaustive quality measures: requiring hip fracture repair surgery within 48 hours – a case study

Overview of attention for article published in Israel Journal of Health Policy Research, November 2017
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2 tweeters

Citations

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5 Dimensions

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9 Mendeley
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Title
The danger of non-exhaustive quality measures: requiring hip fracture repair surgery within 48 hours – a case study
Published in
Israel Journal of Health Policy Research, November 2017
DOI 10.1186/s13584-017-0189-5
Pubmed ID
Authors

Kobi Peleg, Michael Rozenfeld, Avi Israeli

Abstract

Quality measures are widely used globally in order to measure clinical performance and organizational efficiency of the healthcare systems. However, in a race to achieve certain numerically defined goal, the more important purpose of any organizational step being aimed at improving clinical outcomes could be overshadowed.The introduction of the requirement to perform most hip fracture surgeries in the first 48 h of hospitalization by the Israeli Ministry of Health (IMOH) provides an interesting example of the complexity of this phenomenon. In 2004, the IMOH decided that hospitals would receive the full DRG payment for hip fractures operations only in cases in which the operation is performed within 48 h of hospitalization. In 2013, the IMOH proceeded to designate the proportion of less than 48 h surgeries as an official quality parameter for comparing hospital performance.Despite the widely acknowledged and proven clinical benefit of earlier surgery for hip fracture patients, the desired proportion of such surgeries in a given population is not easily defined for a given population, as a significant number of patients may be unsuited for immediate surgery due to medical instability, having a serious co-morbidity or receiving anticoagulant treatment. Rushing these patients to surgery can be therefore expected to have a negative effect on their outcomes, and the subsequent increase in hip fracture mortality recorded in Israel after 2013 may be a result of that.This example suggests that designating an organizational quality measure without adjusting it for the patient's medical condition may make it too inaccurate to guide healthcare policy.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 9 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 9 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 2 22%
Unspecified 1 11%
Researcher 1 11%
Professor 1 11%
Unknown 4 44%
Readers by discipline Count As %
Medicine and Dentistry 3 33%
Business, Management and Accounting 1 11%
Unspecified 1 11%
Unknown 4 44%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 December 2017.
All research outputs
#9,777,664
of 12,236,571 outputs
Outputs from Israel Journal of Health Policy Research
#189
of 304 outputs
Outputs of similar age
#243,375
of 340,433 outputs
Outputs of similar age from Israel Journal of Health Policy Research
#14
of 24 outputs
Altmetric has tracked 12,236,571 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 304 research outputs from this source. They receive a mean Attention Score of 2.7. This one is in the 29th percentile – i.e., 29% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 340,433 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 17th percentile – i.e., 17% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 24 others from the same source and published within six weeks on either side of this one. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.