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[Underestimation of medical activity measured by daily activity scores]
1Service de Réanimation Polyvalente, Institut Mutualiste Montsouris, Paris.
Objectives:
To assess the effectiveness of a scoring system (omega) for medical activity.
Methods:
In 100 consecutive patients (phase A), the omega scores were calculated by the physician in charge and controlled by an independent physician. In 100 additional patients, the omega scores were controlled again while using corrective measures (phase B).
Results:
Phase A: at least one item was forgotten in 54% of the stays. The amount of medical activity lost (MAL) was 14 +/- 13%. Phase B: there was no significant reduction in the number of stays with forgotten items (45%, p = 0.41 vs phase A) and the MAL was 17 +/- 16% (p = 0.19 vs 6 +/- 10 days, p = 0.002) and high omega II score (items recorded every time they are performed) (0.8 +/- 1.3 vs 0.4 +/- 0.7, p = 0.01) were associated with forgetting items. The MAL was negatively correlated with the length of stay (r = -0.69, p < 0.001) and omega score (r = -0.40, p = 0.001).
Conclusion:
In routine practice, scoring systems may underestimate medical activity.