Biostat Laboratory Activity #2

Statement of the Problem and Summative Report of Related Literatures

Group No: 6__________ Section: 3CMT__ Date: September 26, 2017______ Score: ______

Group Members:

1. GUMARAO, Araceli__________________ 6.MADRID, Marie Allen____________

2. HERNAEZ, Daphne___________________ 7._____________________________
3. IGLESIAS, Stefanie___________________ 8._____________________________
4. LACSON, Trizelle____________________ 9._____________________________
5. MACASAET, Katrina__________________ 10.____________________________

___________________________________________________________________________________

Topic : The Most Common Complaints Of Patients In The University Of Santo Tomas Hospital
Major Problem: Patient satisfaction to the quality management of the University of Santo Tomas
Hospital

Sub-Problems:
1. Perceived satisfaction levels of patients using the UST hospital services
2. Problems that patients encountered upon using the service
Source Summative Report Prepared
by:
1 Title: A profile of deaths among trauma patients
in a university hospital: The Philippine experience
Consuji, R. J., Marinas, J. GUMARAO
P. E. S., Maddumba, J. R.
Objectives: The purpose of this study is to
A. & Dela Paz Jr, D. A.
describe the mortality patterns of the first trauma
https://www.ncbi. service (Philippine General Hospital) in 1989.
nlm.nih.gov/pmc/
articles/PMC3134925/ Methodology used: A descriptive and
retrospective 3-year review, covering January
2004 June 2007, was conducted using an
electronic patient database. Review of patient
records included: population demographics,
mechanism of injury, length of stay prior to
death, and the cause of death.

Respondents: 4947 patients admitted to the

Division of Trauma during the study period
Sampling technique used: Stratified Sampling

Statistical tests used: Independent T-test

 Findings:
Of the 4947 patients admitted to the Division of
Trauma during the study period, there were 231
(4.7%) deaths. The most common mechanisms of
injuries were stab wounds (32.9 %), vehicular
crashes (28.6 %), and gunshot wounds (25.5 %).
Multiple organ failure/Sepsis (37.7 %) was the
most frequent causes of death, followed by
Exsanguinations (27.7 %), Central Nervous System
failure (18.6 %) and other causes (10.8%). Forty
four (66.7 %) of the 66 patients who died within
the first 24 hours died from Exsanguinations,
while 66 (61.1 %) of the 8 patients who died after
72 hours died from Multiple organ failure/Sepsis.

Intentional causes of injury (i.e. penetrating

interpersonal violence) caused the majority of
trauma deaths in this series from the Philippine
General Hospital. This highlights the need for
prioritizing a public health approach to violence
prevention in the Philippines. Further research
must be conducted to identify risk factors for
interpersonal violence. Early identification of
lethal injuries that may cause exsanguinations
and definitive control of hemorrhage should be
the primary focus to prevent acute deaths, within
24 hours of admission. Further adjuncts to the
definitive treatment of hemorrhage, the critical
care of TBI and MOF/Sepsis are needed to reduce
deaths occurring more than 72 hours after
admission.

2 Title: Patient complaints in healthcare systems: a

systematic review and coding taxonomy
Tom W Reader, Alex HERNAEZ
Gillespie, Jane Roberts
Objectives:
Describing the characteristics of
http://qualitysafety.
bmj.com/content/ patient complaint studies.
early/2014/05/29/bmjqs- Describing the methodologies used
2013-002437 to collect and analyse patient
complaint data.
 Reporting on and consolidating the
issues identified as underlying
patient complaints across the
literature.
Sorting and thematically grouping
the issues identified as underlying
patient complaints in order to
develop a data-driven patient
complaint coding taxonomy
outline the practices used to code
analyse patient complaints
to describe the types and
prevalence of issues underlying
patient complaints
Methodology used:
Study selection-The starting eligibility
criteria were articles reporting primary
data on patient complaints in English. A
search strategy to select relevant papers was
then applied.
Data extraction and analysis-extracted by
a single reviewer (JR), and then
checked by a second reviewer (TR/AG).
The process consisted of the following four
phases.
o Phase I: descriptive data
o Phase II: methodological data
o Phase III: issues raised in patient
complaints
o Phase IV: developing a complaint
coding taxonomy
****Data were extracted and synthesised
on
(1) basic study characteristics
(2) methodological details
(3) the issues patients complained about

Respondents: Reporting 88 069 patient

complaints

Sampling technique used: Systematic sampling

Statistical tests used: Independent T-test


3 Title of the Study: Patient safety and quality of
Harrison, R. & Walton,M.
https://academic.oup.
com/intqhc/article/27/
4/240/2357347/Patient-
safety-and-quality-of-care-in-
developing#37526530
Findings:
59 studies, reporting 88 069 patient complaints,
were included. Patient complaint coding
methodologies varied considerably (eg, in
attributing single or multiple causes to
complaints). In total, 113 551 issues were found
to underlie the patient complaints. These were
analysed using 205 different analytical codes
which when combined represented 29
subcategories of complaint issue. The most
common issues complained about were
treatment (15.6%) and communication (13.7%).
To develop a patient complaint coding taxonomy,
the subcategories were thematically grouped into
seven categories, and then three
conceptually distinct domains. The first domain
related to complaints on the safety and quality of
clinical care (representing 33.7% of complaint
issues), the second to the management of
healthcare organisations (35.1%) and the third to
problems in healthcare staffpatient relationships
(29.1%)
care in developing countries in Southeast Asia: a
systematic literature review IGLESIAS
Objectives:
To establish the frequency and types of
patient safety events and quality of care
issues reported in developing countries in
Southeast Asia.
To identify patient safety and quality
improvement activities and interventions
in healthcare services in these countries.
To identify any contextual considerations
and challenges for patient safety and
healthcare quality research.
Methodology: The Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA)
statement is an evidence-based approach for
reporting in systematic reviews and meta-
 analyses. The PRISMA statement was used to
guide the reporting of this systematic review.

Respondents: Healthcare organizations, staff,

patients and/or families of patients in Southeast
Asian countries as defined by the Human
Development Index.

Sampling Techinique used: Random Sampling

Statistical Test used: Pearson correlation

Findings: Quality and safety of patient care in

developing countries in Southeast Asia is
understudied. This review indicates that unsafe
and poor quality care is a problem; in particular,
infection, medication error or misuse and lack of
patient safety skills and knowledge in maternal
and perinatal care. It is critical that clinicians and
patient safety researchers collaborate with their
counterparts in developing countries in Southeast
Asia, sharing expertize and experiences to
improve understanding of patient safety and
quality of care. Such work must consider the
applicability of existing strategies in other cultural
and political contexts.

4 Title: Emergency hospital admissions for the

elderly: insights from the Devon Predictive
T. Chenore D.J. Pereira Model LACSON
Gray J. Forrer C. Objectives:
Wright P.H. Evans To explore the relationship between
the age of the registered population
https://academic.
and the rate of emergency admissions
oup.com/jpubhealth/
article/35/4/616/168 to hospital, especially the effect of age
5800/Emergency- of 85 and above.
hospital-admissions To build a model to predict emergency
-for-the-elderly#849 admissions in Devon using local
73465 factors
To compare the accuracy of the
predictions of the new model (DPM)
with those of the existing model
(CPM).
Methodology used:All emergency
admissions for the registered population in
Devon to all English hospitals were analysed
by age, and admission rates per thousand
registered were calculated. The Devon
Predictive Model (DPM) was built, using local
data, to predict emergency admissions in the
following 12 months. This model was
compared with the Combined Predictive
Model over five risk categories.

Respondents:The registered Devon

population on 31 March 2011 was 761 652
with 65 892 emergency admissions in
2010/2011.
Sampling technique used: Cluster Sampling
Statistical tests used:exploratory
multivariate linear regression
Findings:
The DPM, in a population with 3.3%
aged 85 and over, revealed the
substantial influence of old age on
emergency admission to local
hospitals. In Devon, half (49.5%) of all
emergency admissions in 2011 were
for people aged 65 and over and,
among people aged 85 and over, there
were 420 emergency admissions per
thousand registered patients in a
single year.
The DPM significantly outperformed
the CPM in all the five risk categories.
Of the 200 people in the group
predicted by the DPM to be most at
risk of emergency admission, 143
(86%) were subsequently admitted
30 more emergency admissions
correctly predicted than by the CPM.
A new finding was that 95.7% of all
emergency admissions were to local
hospitals. They reflect local decisions,
for local people with local age
structures, using local resources, and
local work patterns. Local data reflect
these; hence it is logical for the DPM to
incorporate them.
5 Title of study: Mortality by cause for eight regions
Christopher JL Murray DPhil
and Alan D Lopez PhD
http://www.science
direct.com/science/
article/pii/S0140673
696074934
of the world: Global Burden of Disease Study
MACASAET
Objectives:
To develop internally consistent estimates
of mortality for 107 causes of death by
age, sex, and geographic region.
To develop internally consistent
estimates of incidence, prevalence,
duration, and case-fatality for 483
disabling sequelae of the 107 causes.
To estimate the fraction of mortality
and disability attributable to ten major
risk factors.
To develop various projection scenarios
of mortality and disability estimates by
cause, age, sex, and region.
Methodology used:
Preliminary estimates were developed with
available vital-registration data, sample-
registration data for India and China, and small-
scale population-study data sources. Registration
data were corrected for miscoding, and Lorenz-
curve analysis was used to estimate cause-of-
death patterns in areas without registration.
Preliminary estimates were modified to reflect
the epidemiology of selected diseases and
injuries. Final estimates were checked to ensure
that numbers of deaths in specific age-sex groups
did not exceed estimates suggested by
independent demographic methods.
Respondents: 14 age-sex groups in eight regions,
for 107 causes
Sampling technique used: Stratified sampling
Statistical tests used: Spearman correlation
Findings:
98% of all deaths in children younger than 15
years are in the developing world. 83% and 59%
 of deaths at 1559 and 70 years, respectively, are
in the developing world. The probability of death
between birth and 15 years ranges from 220% in
sub-Saharan Africa to 11% in the established
market economies. Probabilities of death
between 15 and 60 years range from 72% for
women in established market economies to
391% for men in sub-Saharan Africa. The
probability of a man or woman dying from a non-
communicable disease is higher in sub-Saharan
Africa and other developing regions than in
established market economies. Worldwide in
1990, communicable, maternal, perinatal, and
nutritional disorders accounted for 172 million
deaths, non-communicable diseases for 281
million deaths and injuries for 51 million deaths.
The leading causes of death in 1990 were
ischaemic heart disease (63 million deaths),
cerebrovascular accidents (44 million deaths),
lower respiratory infections (43 million),
diarrhoeal diseases (29 million), perinatal
disorders (24 million), chronic obstructive
pulmonary disease (22 million), tuberculosis (20
million), measles (11 million), road-traffic
accidents (10 million), and lung cancer (09
million).

6 Title of study: The profile of patients

complaints in a regional hospital
Alireza Jabbari, Elahe Objectives: MADRID
Khorasani, Marzie Jafarian to identify the frequency distribution of the
Jazi, Maryam Mofid, Raja people complained about, the units
Mardani complained about, the total number of
complaints, and frequency distribution of
the results of complaints.
https://www.ncbi. Methodology used:
nlm.nih.gov/pmc/ This examination is a spellbinding, review
articles/PMC3992788/
cross-sectional investigation in which its
information was gathered in the wake of getting
consent from separate specialists. In the agenda of
gathering information, the units whined about, the
individual griped about, and the aftereffects of
grievances were explored. The reason and asset of
grievances issues were inspected in this
investigation, however their estimations were
impractical because of the absence of exact
enrollment data. For moral contemplations,
information were kept as secret and dissected
namelessly. For information investigation, Excel
programming program was utilized.
Respondents:
Complaints on Medical staff, nursing staff,
administrative staff, security staff, servicing staffs,
and the complained about in the hospital divided
into quarters (emergency department, clinic, food
service units etc.)
Sampling technique used: Stratified sampling
Statistical tests used: Paired T-test
Findings:
Findings of the present study show that the
highest number of complaint cases against
individuals (143 cases) was recorded in the second
quarter of the year 2012 compared to other months
of the year, and the lowest number (90 cases) was
recorded in the last quarter of 2013. In the second
quarter of 2012, the highest rate of complaints was
filed against nursing staff (35.7%) and the lowest
rate of complaints (6.3%) was filed against
servicing staff. In the third quarter of 2012, the
highest rate of complaints (39.5%) was filed
against medical staff and the lowest against
administrative staff. In the fourth, the highest
(42.9%) and the lowest (7.6%) numbers of
complaints were filed against medical staff and
servicing personnel, respectively. In the first
quarter of 2013, the highest number of complaints
was filed against medical staff (54.4%) and the
lowest against servicing personnel (3.3%).
Findings indicate that despite the overall
drop in the total number of complaints, the
number of complaints about medical staff
increased. The nursing staff were the next highly-
complained-about individuals during the
investigated period.
Findings show that in the third quarter of
2012 compared to other months of the investigated
period, the highest number of complaints (229
cases) was filed against the hospital units while
the lowest number of complaints against these
units were filed in the first quarter of 2013 (94
cases). In the second quarter of 2012, the highest
 number of complaints was filed against private
booths (30.4%) and the lowest was against special
clinic (6.2%). In the third quarter of 2012, the
highest number of complaints was filed against
administration and support units (22.3%) and the
lowest number was filed against food service units
(3.1%). In the fourth quarter of 2012, the highest
number of complaints was filed against private
booths (31.4%) and the lowest number of
complaints was filed against hygiene (9.5%). In
the first quarter of 2013, the highest number of
complaints was filed against clinics (42.6%) and
the lowest number was against hygiene (0.0%).