American journal of public health
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Comparative Study
Comparing hospitals that perform coronary artery bypass surgery: the effect of outcome measures and data sources.
The relative quality of hospital care often is judged by comparing risk-adjusted rates of adverse outcomes. This study evaluated whether hospital quality comparisons are affected by the choice of outcome and the use of administrative data instead of clinical data. ⋯ These results suggest assessing quality of care by the use of administrative data may not be adequate and that quality assessment by the use of clinical data may depend greatly on the outcome chosen.
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Studies of the relationship between hysterectomy use and sociodemographic factors tend to use self-reported data. In the current study, data were collected from a representative sample of US women who have been prospectively followed since 1971. ⋯ Although these two measures of hysterectomy were highly related, more women reported hysterectomy than could be confirmed by hospital records. The two measures showed similar associations between several obstetric and demographic characteristics and hysterectomy status, suggesting that the use of self-reported hysterectomy data does not bias analyses of potentially associated factors.
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This study evaluated the effectiveness of a community coalition to prevent severe injuries to children in Central Harlem, New York, NY. It was hypothesized that injury incidence rates would decline during the intervention (1989 through 1991) relative to preintervention years (1983 through 1988); that the decline would be greatest for the targeted age group (5 through 16 years) and targeted injury causes (traffic accidents, assaults, firearms, outdoor falls); and that the decline would occur in the intervention community rather than a control community. ⋯ The declining incidence rate in Central Harlem is consistent with a favorable program effect, but additional investigation of possible secular trend or spillover effects is needed.
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Suicidal ideation and attempts were examined in a population of chemically dependent adolescents, a group at high risk of self-destructive behavior. ⋯ The probability of a suicide attempt increases when thoughts of suicide coincide with morbid ideation of extended duration, suggesting that risk assessment should be based on duration as well as presence of morbid thoughts. Substance abuse treatment requires an assessment of suicidal potential and counseling for those whose potential is high, with special attention to males exposed to abuse.