Validity of anaesthetic complication coding data as a clinical indicator.

Clinical indicators using routinely collected International Statistical Classification of Diseases, Australian Modification (ICD-10-AM) data offer promise as tools for improvement of quality. The ICD-10-AM is the coding system used by Australian administrators to summarise information from the clinical record to describe a patient's hospital encounter. The use of anaesthesia complications as coded by this system has been proposed by two jurisdictions as a monitor of the quality of anaesthetic services. We undertook a review of cases identified by such indicators in a large tertiary hospital. Our results indicate the anaesthesia indicator dataset proposed by the Victorian and Queensland Health departments appears to have little clinical or quality improvement relevance.

Rapid assessment of health status and preventive - medicine needs of newly arrived Kampuchean refugees, Sa Kaeo, Thailand

In the disaster relief programme for Kampuchean refugees in Thailand, epidemiological techniques were incorporated into the health-planning process during the first 2 weeks of the refugee influx. The findings influenced not only health care in the first refugee camp but also the delivery of medical services in subsequent camps. The mortality rate in the first week of refugee settlement was 9.1/10000/day, and fell to 0.7/10000/day by the fifth week. Children aged 4 and under had the highest risk of death. Fever/malaria was the main cause of morbidity and mortality. Simple epidemiological techniques, if initiated early in the relief effort, can influence medical decisions and lead to more effective use of health resources(AU)