Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1155/2014/989815 http://hdl.handle.net/11449/220390 |
Resumo: | Objective. To assess quality of care of women with severe maternal morbidity and to identify associated factors. Method. This is a national multicenter cross-sectional study performing surveillance for severe maternal morbidity, using the World Health Organization criteria. The expected number of maternal deaths was calculated with the maternal severity index (MSI) based on the severity of complication, and the standardized mortality ratio (SMR) for each center was estimated. Analyses on the adequacy of care were performed. Results. 17 hospitals were classified as providing adequate and 10 as nonadequate care. Besides almost twofold increase in maternal mortality ratio, the main factors associated with nonadequate performance were geographic difficulty in accessing health services (P < 0.001), delays related to quality of medical care (P = 0.012), absence of blood derivatives (P = 0.013), difficulties of communication between health services (P = 0.004), and any delay during the whole process (P = 0.039). Conclusions. This is an example of how evaluation of the performance of health services is possible, using a benchmarking tool specific to Obstetrics. In this study the MSI was a useful tool for identifying differences in maternal mortality ratios and factors associated with nonadequate performance of care. |
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spelling |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance StudyObjective. To assess quality of care of women with severe maternal morbidity and to identify associated factors. Method. This is a national multicenter cross-sectional study performing surveillance for severe maternal morbidity, using the World Health Organization criteria. The expected number of maternal deaths was calculated with the maternal severity index (MSI) based on the severity of complication, and the standardized mortality ratio (SMR) for each center was estimated. Analyses on the adequacy of care were performed. Results. 17 hospitals were classified as providing adequate and 10 as nonadequate care. Besides almost twofold increase in maternal mortality ratio, the main factors associated with nonadequate performance were geographic difficulty in accessing health services (P < 0.001), delays related to quality of medical care (P = 0.012), absence of blood derivatives (P = 0.013), difficulties of communication between health services (P = 0.004), and any delay during the whole process (P = 0.039). Conclusions. This is an example of how evaluation of the performance of health services is possible, using a benchmarking tool specific to Obstetrics. In this study the MSI was a useful tool for identifying differences in maternal mortality ratios and factors associated with nonadequate performance of care.Consiglio Nazionale delle RicercheDepartment of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), R. Alexander Fleming 101, P.O. Box 6030Centre for Research on Reproductive Health of Campinas (Cemicamp), R. Vital Brasil 200Federal University of AmazonasCISAM, School of Medical SciencesFederal University of CearáFederal University of BahiaHospital Geral Cesar CalsHospital Geral de FortalezaMaternidade Odete ValadaresHospital Materno InfantilIMIPFederal University of PernambucoFederal University of Campina GrandeFederal University of MaranhãoFederal University of ParanáFederal University of ParaíbaHospital Maternidade Fernando MagalhãesFederal University of Rio Grande Do sulHospital Maternidade Celso PierroInstituto Fernandes FigueiraHospital Israelita Albert EinsteinUniversity of the State of São PauloJundiaí School of MedicineUniversity of São PauloSanta Casa de LimeiraSanta Casa de São CarlosMaternidade Leonor Mendes de BarrosFederal University of São PauloConsiglio Nazionale delle Ricerche: 402702/2008-5Universidade Estadual de Campinas (UNICAMP)Centre for Research on Reproductive Health of Campinas (Cemicamp)Federal University of AmazonasCISAM, School of Medical SciencesFederal University of CearáUniversidade Federal da Bahia (UFBA)Hospital Geral Cesar CalsHospital Geral de FortalezaMaternidade Odete ValadaresHospital Materno InfantilIMIPUniversidade Federal de Pernambuco (UFPE)Federal University of Campina GrandeFederal University of MaranhãoFederal University of ParanáFederal University of ParaíbaHospital Maternidade Fernando MagalhãesFederal University of Rio Grande Do sulHospital Maternidade Celso PierroInstituto Fernandes FigueiraHospital Israelita Albert EinsteinUniversity of the State of São PauloJundiaí School of MedicineUniversidade de São Paulo (USP)Santa Casa de LimeiraSanta Casa de São CarlosMaternidade Leonor Mendes de BarrosHaddad, Samira MaerrawiCecatti, Jose GuilhermeSouza, Joao PauloSousa, Maria HelenaParpinelli, Mary AngelaCosta, Maria LauraPacagnella, Rodolfo C.Brum, Ione R.Moraes Filho, Olímpio B.Feitosa, Francisco E.Menezes, Carlos A.Guanabara, Everardo M.Moreira, Joaquim L.Peret, Frederico A.Schmaltz, Luiza E.Katz, LeilaLima, Antonio C. BarbosaAmorim, Melania M.Martins, Marilia G.Nascimento, Denis J.Paiva, Cláudio S.Rohloff, Roger D.Costa, Sergio M.Luz, Adriana G.Lobato, GustavoCordioli, EduardoPeraçoli, Jose C.Maia Filho, Nelson L.Quintana, Silvana M.Lotufo, Fátima A.Andreucci, Carla B.Aquino, Márcia M.Mattar, Rosiane2022-04-28T19:01:09Z2022-04-28T19:01:09Z2014-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1155/2014/989815BioMed Research International, v. 2014.2314-61412314-6133http://hdl.handle.net/11449/22039010.1155/2014/9898152-s2.0-84931587491Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengBioMed Research Internationalinfo:eu-repo/semantics/openAccess2022-04-28T19:01:10Zoai:repositorio.unesp.br:11449/220390Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T22:45:17.836344Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
title |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
spellingShingle |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study Haddad, Samira Maerrawi |
title_short |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
title_full |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
title_fullStr |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
title_full_unstemmed |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
title_sort |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
author |
Haddad, Samira Maerrawi |
author_facet |
Haddad, Samira Maerrawi Cecatti, Jose Guilherme Souza, Joao Paulo Sousa, Maria Helena Parpinelli, Mary Angela Costa, Maria Laura Pacagnella, Rodolfo C. Brum, Ione R. Moraes Filho, Olímpio B. Feitosa, Francisco E. Menezes, Carlos A. Guanabara, Everardo M. Moreira, Joaquim L. Peret, Frederico A. Schmaltz, Luiza E. Katz, Leila Lima, Antonio C. Barbosa Amorim, Melania M. Martins, Marilia G. Nascimento, Denis J. Paiva, Cláudio S. Rohloff, Roger D. Costa, Sergio M. Luz, Adriana G. Lobato, Gustavo Cordioli, Eduardo Peraçoli, Jose C. Maia Filho, Nelson L. Quintana, Silvana M. Lotufo, Fátima A. Andreucci, Carla B. Aquino, Márcia M. Mattar, Rosiane |
author_role |
author |
author2 |
Cecatti, Jose Guilherme Souza, Joao Paulo Sousa, Maria Helena Parpinelli, Mary Angela Costa, Maria Laura Pacagnella, Rodolfo C. Brum, Ione R. Moraes Filho, Olímpio B. Feitosa, Francisco E. Menezes, Carlos A. Guanabara, Everardo M. Moreira, Joaquim L. Peret, Frederico A. Schmaltz, Luiza E. Katz, Leila Lima, Antonio C. Barbosa Amorim, Melania M. Martins, Marilia G. Nascimento, Denis J. Paiva, Cláudio S. Rohloff, Roger D. Costa, Sergio M. Luz, Adriana G. Lobato, Gustavo Cordioli, Eduardo Peraçoli, Jose C. Maia Filho, Nelson L. Quintana, Silvana M. Lotufo, Fátima A. Andreucci, Carla B. Aquino, Márcia M. Mattar, Rosiane |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual de Campinas (UNICAMP) Centre for Research on Reproductive Health of Campinas (Cemicamp) Federal University of Amazonas CISAM, School of Medical Sciences Federal University of Ceará Universidade Federal da Bahia (UFBA) Hospital Geral Cesar Cals Hospital Geral de Fortaleza Maternidade Odete Valadares Hospital Materno Infantil IMIP Universidade Federal de Pernambuco (UFPE) Federal University of Campina Grande Federal University of Maranhão Federal University of Paraná Federal University of Paraíba Hospital Maternidade Fernando Magalhães Federal University of Rio Grande Do sul Hospital Maternidade Celso Pierro Instituto Fernandes Figueira Hospital Israelita Albert Einstein University of the State of São Paulo Jundiaí School of Medicine Universidade de São Paulo (USP) Santa Casa de Limeira Santa Casa de São Carlos Maternidade Leonor Mendes de Barros |
dc.contributor.author.fl_str_mv |
Haddad, Samira Maerrawi Cecatti, Jose Guilherme Souza, Joao Paulo Sousa, Maria Helena Parpinelli, Mary Angela Costa, Maria Laura Pacagnella, Rodolfo C. Brum, Ione R. Moraes Filho, Olímpio B. Feitosa, Francisco E. Menezes, Carlos A. Guanabara, Everardo M. Moreira, Joaquim L. Peret, Frederico A. Schmaltz, Luiza E. Katz, Leila Lima, Antonio C. Barbosa Amorim, Melania M. Martins, Marilia G. Nascimento, Denis J. Paiva, Cláudio S. Rohloff, Roger D. Costa, Sergio M. Luz, Adriana G. Lobato, Gustavo Cordioli, Eduardo Peraçoli, Jose C. Maia Filho, Nelson L. Quintana, Silvana M. Lotufo, Fátima A. Andreucci, Carla B. Aquino, Márcia M. Mattar, Rosiane |
description |
Objective. To assess quality of care of women with severe maternal morbidity and to identify associated factors. Method. This is a national multicenter cross-sectional study performing surveillance for severe maternal morbidity, using the World Health Organization criteria. The expected number of maternal deaths was calculated with the maternal severity index (MSI) based on the severity of complication, and the standardized mortality ratio (SMR) for each center was estimated. Analyses on the adequacy of care were performed. Results. 17 hospitals were classified as providing adequate and 10 as nonadequate care. Besides almost twofold increase in maternal mortality ratio, the main factors associated with nonadequate performance were geographic difficulty in accessing health services (P < 0.001), delays related to quality of medical care (P = 0.012), absence of blood derivatives (P = 0.013), difficulties of communication between health services (P = 0.004), and any delay during the whole process (P = 0.039). Conclusions. This is an example of how evaluation of the performance of health services is possible, using a benchmarking tool specific to Obstetrics. In this study the MSI was a useful tool for identifying differences in maternal mortality ratios and factors associated with nonadequate performance of care. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-01-01 2022-04-28T19:01:09Z 2022-04-28T19:01:09Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1155/2014/989815 BioMed Research International, v. 2014. 2314-6141 2314-6133 http://hdl.handle.net/11449/220390 10.1155/2014/989815 2-s2.0-84931587491 |
url |
http://dx.doi.org/10.1155/2014/989815 http://hdl.handle.net/11449/220390 |
identifier_str_mv |
BioMed Research International, v. 2014. 2314-6141 2314-6133 10.1155/2014/989815 2-s2.0-84931587491 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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BioMed Research International |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1808129458765299712 |