Instead we have identified a number of factors which may have led to the unusually high level of complications seen.
Since a high level of complications express low quality, and vice versa, the complications term should be multiplied by −1 in order to comprehend the cost-quality association from the finings.
This reluctance may be due to perception of harm and perceived high level of complications despite published articles supporting the safety and efficacy of this treatment.
19 Because of the high level of complications throughout the course of Alzheimer's disease, we highlighted the necessity of comprehensive standardised evaluations every six months in memory clinics, including cognitive and non-cognitive assessment.
The high levels of complications requiring surgical intervention published in the literature have led to concerns over the cost-effectiveness as well as safety of the procedure.
Generally, when we analyse the impact of quality on costs at patient level, we would expect to find that high levels of complications are positively related to costs, since patients with complications are costly.
It is acknowledged that levels of adherence to targets are likely to be overestimated in our findings because of the absence of data for persistently nonattending patients and possibly those with high levels of complications, who may be less able or willing to consent to take part in research.
High levels of complications were common: 23% had antenatal hospital admissions, 50% of women were anaemic (Hb <11.0 g/dl), 45% had abnormal urine test results indicating UTI, 21% had preterm labour resulting in preterm birth, and 22% were recorded to have sexually transmitted infections [ 20].
In Denmark, pregnant women have shared antenatal care provided by a general practitioner and a midwife who are both responsible for screening of pregnant women for risk factors and referral to a higher level of care in case of complications or indications of such.
Fowler et al. showed that MRSA ST30 was associated with a significant trend towards higher levels of hematogenous complications [31].
