Case study 1
There is significant heterogeneity in the decision to hospitalise patients from the emergency department (ED). In this study, the consortium aims to evaluate the propensity of the participating EDs to hospitalise their patients, comparing the hospitalisation rate after adjusting for the differences among the case-mixes of the centres. An accurate and adjusted measure of the hospitalisation rate will be used to investigate the association between the ED’s attitude towards the disposition decision and a short-term clinical outcome (i.e., 30-day survival).
Primary objectives:
To evaluate the feasibility of an automated extraction from the ED EHRs of the characteristics deemed essential for the benchmarking model predicting the ED disposition decision.
For patients presenting following loss of consciousness or with dyspnea at ED arrival, to evaluate whether the extracted information from the free text sections of the EHRs adds relevant predictive information to the characteristics that can be obtained from structured (not free text) sources.
To provide the participating EDs with an adjusted comparison of the hospitalisation rate for the patients with selected symptoms.
Secondary objective:
To assess the association of the constructed indicator with 30-day survival.
See the protocol for more information:
Study protocol - Propensity to hospitalize patients from the ED in European centers. An observational retrospective quality-of-care study.
Bertolini G, Banzi R, Catania F, Lavelli A, Ghilardi GI, Pandolfini C, Nattino G (2024).