Evaluation of Quality Indicators on Analgesia, Sedation and Delirium in Intensive Care Patients and Their Impact on Outcome Indicators and Economic Indicators

Completed

• Conditions: Pain; Delirium

• Registration Number: NCT05384613
• Lead Sponsor: Charite University, Berlin, Germany

Brief Summary

Retrospective cohort study to investigate the adherence to the process indicators for pain management, sedation management and management of delirium on outcome indicators and cost/revenues in individual patients and subcohorts.

Detailed Description

The evaluation of quality-related process indicators (in this case, Quality Indicator II of the Intensive Care Quality Indicators of the DIVI\*: Management of Analgesia, Sedation and Delirium) will be correlated with economic parameters of the treatment from economic data (DRG revenue, case costs). Data from clinical routine care from the Charite hospital systems will be used with further analysis of outcome indicators from routine data (e.g. 30-day readmission rate, mortality, infection rate, length of stay). The aim of the study is to identify and evaluate incentive mechanisms for the implementation of quality-relevant care processes using the example of adherence to a quality indicator regarding management of analgesia, sedation and delirium) on detailed cost shares and case proceeds. In addition, further routine data, which may represent influencing factors like comorbidities (Charlson Comorbitity Index) are calculated using the ICD-10 coding. Also procedures using the OPS system are evaluated.

In this retrospective cohort study, patient records from the clinical information systems from 2012 to 2021 will be analyzed.. The analysis is also intended to analyze whether alternatively, cross-treatment outcome indicators can be defined, which would demonstrate not only positive patient-oriented results but also positive economic results as a potential incentive for health care service providers.

(\* DIVI: Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin = German Interdisciplinary Association for Intensive Care and Emergency Medicine)

Study Timeline

• Study Start: 2022-05-12
• Study First Submitted: 2022-05-17
• Study First Submitted QC: 2022-05-17
• Study First Posted: 2022-05-20
• Primary Completion: 2023-01-16
• Study Completion: 2024-08-01
• Status Verified: 2025-02
• Last Update Submitted: 2025-02-12
• Last Update Posted: 2025-02-14

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 20220

Inclusion Criteria

• Age ≥ 18 years

Exclusion Criteria

• Incomplete electronic records

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Influence of compliance to a quality indicator (Monitoring sedation, analgesia, delirium)	01.01.2012- 31.12.2021	Influence of compliance to a quality indicator (Quality Indicator II of the DIVI; Management of Analgesia, Sedation and Delirium) and the relationship to case specific revenues and case costs according to case-specific analysis based on hospital financial data

Secondary Outcome Measures

Name	Time	Method
Comorbidity scores	01.01.2012- 31.12.2021	(Comorbidity scores are assessed according to Charlson comorbidity index (CCI) employing routine data, like icd-10 codes.
Outcome indicators	01.01.2012- 31.12.2021	Outcome indicators from routine data are e. g. 30-day readmission rate, mortality, infection rate, length of stay, etc. )

Trial Locations

Locations (1)

Charité - University Medicine Berlin; 🇩🇪 Berlin, Germany