Facilitating Cross-national comparisons of indicators for patient safety at the health-system level in the OECD countries. Faciliter les comparaisons transnationales des indicateurs concernant la sécurité du patient au niveau du système de santé dans les pays de l'OCDE.

DELSA/ELSA/WD/HTP(2008)1
OECD HEALTH TECHNICAL PAPERS
FACILITATING CROSS-NATIONAL
COMPARISONS OF INDICATORS FOR
PATIENT SAFETY AT THE HEALTH-SYSTEM
LEVEL IN THE OECD COUNTRIES
Saskia Drösler
19

Unclassified DELSA/ELSA/WD/HTP(2008)1
Organisation de Coopération et de Développement Économiques
Organisation for Economic Co-operation and Development
07-Apr-2008
___________________________________________________________________________________________
English text only
DIRECTORATE FOR EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS
EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS COMMITTEE
OECD HEALTH TECHNICAL PAPERS NO. 19
FACILITATING CROSS NATIONAL COMPARISONS OF INDICATORS FOR PATIENT SAFETY
AT THE HEALTH SYSTEM LEVEL IN THE OECD COUNTRIES
Saskia Drösler
JT03243700
Document complet disponible sur OLIS dans son format d'origine
Complete document available on OLIS in its original format
DELSA/ELSA/WD/HTP(2008)1 Unclassified
English text only

DELSA/ELSA/WD/HTP(2008)1
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DIRECTORATE FOR EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS
OECD HEALTH TECHNICAL PAPERS
This series is designed to make available to a wider readership methodological studies and statistical
analysis presenting and interpreting new data sources, and empirical results and developments i
n
methodology on measuring and assessing health care and health expenditure. The papers are generall
y
available only in their original language – English or French – with a summary in the other.
Comment on the series is welcome, and should be sent to the Directorate for Employment, Labour an
d
Social Affairs, 2, rue André-Pascal, 75775 PARIS CEDEX 16, France.
The opinions expressed and arguments employed here are the responsibility
of the author(s) and do not necessarily reflect those of the OECD
Applications for permission to reproduce or translate
all or part of this material should be made to:
Head of Publications Service
OECD 2, rue André-Pascal
75775 Paris, CEDEX 16
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Copyright OECD 2008
Health Technical Papers are available at: www.oecd.org/els/health/technicalpapers.

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ACKNOWLEDGEMENTS
The OECD Secretariat is grateful to Saskia Drösler for preparing this manual.
The author1 would like to thank Edward Kelley (Agency for Healthcare Research and Quality), Soeren
Mattke (RAND Corporation), Jürgen Stausberg (University of Duisburg-Essen), members of the
International Methodology Consortium for Coded Health Information (IMECCHI) and Greg Webster,
Eugene Wen, Lori Moskal and Linda Tournay-Lewis (Canadian Institute for Health Information) for their
expert advice in preparing this document. The practical comments provided by Bernard Burnand
(Switzerland), Chantal Couris (France), William Ghali (Canada), Patricia Halfon (Switzerland), Jean-
Marie Januel (France), Jean-Christophe Luthi (Switzerland), Hude Quan (Canada), Patrick Romano (USA)
and Vijaya Sundararajan (Australia) during the initial pilot data collection are greatly appreciated. The
author would also like to thank Niek Klazinga, Sandra Garcia-Armesto and Lihan Wei (OECD Health Care
Quality Indicators Team) for review and comments.
This manual is a planned output of the OECD Health Care Quality
Indicators (HCQI) Project which received financial support from a
grant provided by the European Commission (DG SANCO) during
2007.
1. Saskia Drösler of the Niederrhein University of Applied Sciences.
Please direct enquiries regarding this publication to Dr Niek Klazinga, Coordinator, Health Care Quality Indicator
Project – e-mail: [e-mail], tel: [phone] or the Project Contacts specified on the website:
http://www.oecd.org/health/hcqi.

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SUMMARY
This publication was prepared to support the overall work of the OECD Health Care Quality Indicators
Project in developing a set of indicators that can be used to raise questions for investigation concerning the
quality of care across countries.
It provides a manual to facilitate cross national comparisons of indicators for patient safety through the
provision of detailed practical advice on calculating each indicator in a selected set of Patient Safety
Indicators (PSI) utilising national hospital administrative databases.
The selected indicators are:
Area Indicator name
Hospital-acquired infections Infection due to medical care
Decubitus ulcer
Operative and post-operative
complications
Complications of anaesthesia
Postoperative hip fracture
Postoperative pulmonary embolism (PE) or deep vein thrombosis
(DVT)
Postoperative sepsis
Technical difficulty with procedure
Postoperative respiratory failure
Iatrogenic pneumothorax
Sentinel events Transfusion reaction
Foreign body left in during procedure
Obstetrics
Birth trauma - injury to neonate
Obstetric trauma – vaginal delivery with instrument
Obstetric trauma – vaginal delivery without instrument
Obstetric trauma - caesarean section
For each of these indicators, the manual provides:
• Generic coding and calculation instructions related to national hospital administrative databases,
• Cross walk from ICD 9 to ICD 10 codes for each indicator,
• Detailed definitions for calculation of indicators, and
• Flow charts for visualising the calculation process.
The manual was originally designed to support the calculation of patient safety indicators in a group of
countries volunteering to participate in the validation of the methodology. However it is anticipated that
the material presented will also be of interest to a wider audience, including researchers and experts
interested in the technical background and construction of the Patient Safety Indicators and other countries
looking to develop internationally comparable health care quality indicators.