Description du projet :
Background: Childbirth can lead to severe complications affecting both mothers and
newborns. Despite elevated rates of medical interventions such as caesarean sections,
neonatal mortality remains stagnant in Switzerland compared with the European
average. These interventions can be potentially iatrogenic, as shown by the steady
increase in post-partum hemorrhage, which has been the main cause of severe
maternal morbidity since 1993. The over-medicalization of childbirth can also lead to
significant increases in healthcare costs, which must be weighed against quality of
care indicators. There is great variability in medical practices between the different
Swiss cantons, providing an ideal framework for studying associations between
medical practices and perinatal health outcomes. Quality of care indicators have been
developed on the basis of medical practices and perinatal health outcomes. Routine
evaluation of these indicators has shown improvements in the health status of women
and newborns in countries such as in the United Kingdom. To achieve such results, an
information system that can reliably collect data is needed, which is not currently the
case in Switzerland. Currently, the 'Statistique medicale des hôpitaux' is a hospital
discharge database that contains medico-administrative data on hospital stays from all
hospitals in Switzerland. It covers 96% of all births in Switzerland, but it was not
designed for epidemiological research purposes. Our hypothesis is that the use of the
'Statistique medicale des hôpitaux' database could provide a reliable and relevant
source of data for monitoring perinatal quality of care indicators. However, because
this database was originally designed for financial purposes, the quality of the data
collected needs to be assessed.
Aims: The aim of our study will be to assess the validity of perinatal data collected in
the Swiss hospital discharge database.
Material and methods: We propose to conduct a multicenter, cross-sectional
observational study in 16 centers representing the Swiss healthcare system, in order to
assess the validity by comparing the concordance of data collected from 'Statistique
medicale des hôpitaux' with data derived from medical records (gold standard). A total
of 60 variables including data relative to maternal, delivery and neonatal
characteristics, maternal/neonatal morbidity and fetal mortality will be collected from
3100 medical records. Data will be collected blindly from medical records using a
standardized questionnaire. Cohen Kappa scores will be calculated to assess the
degree of agreement. Sensitivity, specificity, positive predictive value, and negative
predictive value of the hospital discharge data will be calculated.
Expected results: The results of this study will enable us to determine whether the
'Statistique medicale des hôpitaux' is a reliable and relevant source of data for
monitoring quality indicators in perinatal care and for conducting large-scale
epidemiological studies in Switzerland.
Implications for practice and research: Algorithms measuring quality indicators of
perinatal care could be built from validated data from the 'Statistique medicale des
hôpitaux'. To improve the reliability of quality of care indicators, coding instructions
could be sent to maternity units each year. This knowledge is essential for improving
the care of women and newborns, guiding perinatal health policies and assessing the
impact of professional practices on the health of mothers and children
Equipe de recherche au sein de la HES-SO:
Lorthe Elsa
, Cattani Gilles
, Rolland-Guillard Louise
, Martin Christie Stéphanie
, Desplanches Thomas
Partenaires académiques: Santé
Durée du projet:
01.03.2025 - 29.02.2028
Montant global du projet: 627'914 CHF
Statut: En cours
SWITCH edu-ID
Administration
