256862 Measuring the quality of EMS care using composite scores

Tuesday, October 30, 2012

Tsung-Tai Chen , Department of Public Health, Fu Jen Catholic University, New Taipei, Taiwan
Patrick Chow-In Ko , Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University, Taiwan, Taipei, Taiwan
Matthew Huei-Ming Ma , Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Fen-Ju Chen , Department of Healthcare Administration, I-Shou University, Kaohsiung City, Taiwan
Background: Policy makers may need to judge the quality of the EMS in terms of its performance rating. However, quality of care is a multidimensional construct that cannot be measured directly. Thus, multiple indicators are used to construct a composite score to measure quality. We investigate the association between the different composite scores developed from EMS-related process measures with post-discharge mortality.

Methods: Data were collected from Taipei City OHCA Registry from the period January 1, 2006 to December 31 2009 Taipei City OHCA Registry. The composite scores were derived from the following methods: the raw sum score and the all-or-none score methods. These composite scores were calculated based on two process measures (EMS response time < 5 minutes and achieving prehospital ROSC). Finally, the association between the composite scores and the risk-adjusted post-discharge mortality was investigated using mixed-effects model.

Results: A total of 4,000 OHCA patients were analyzed. The all-or-none score methods demonstrated a highest inverse relationship with risk-adjusted post-discharge mortality (-0.85, P < 0.01) compared to the raw sum score and individual process measures. The two process measures (EMS response time < 5 minutes and achieving prehospital ROSC) showed the lower inverse relationships with mortality respectively(-0.39 and -0.76 ).

Conclusions: When applying the composite scores, especially the all-or-none score to measure the quality of EMS care, we found they show the higher validity. Hence, the composite score constructed by using a number of process measures may be used as an alternative approach to analyze and access the EMS quality.

Learning Areas:
Other professions or practice related to public health
Provision of health care to the public
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Identify the association between the different composite scores developed from EMS-related process measures with post-discharge mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal and co-principal of nationally funded grants focusing on the research about composite score
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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