Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study

Detalhes bibliográficos
Autor(a) principal: Haddad, Samira Maerrawi
Data de Publicação: 2014
Outros Autores: 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
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.
id UNSP_e3686f691f955ec54d250d357ee97165
oai_identifier_str oai:repositorio.unesp.br:11449/220390
network_acronym_str UNSP
network_name_str Repositório Institucional da UNESP
repository_id_str 2946
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
dc.relation.none.fl_str_mv 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
_version_ 1808129458765299712