Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage
Abstract Background Assessment of quality of care in patients with myocardial infarction (MI) should be based on data that effectively enable determination of quality. With the need to simplify measurement techniques, the question arises whether routine data can be used for this purpose. We therefor...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2016-10-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-016-1840-5 |
| _version_ | 1819133521251270656 |
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| author | Birga Maier Katrin Wagner Steffen Behrens Leonhard Bruch Reinhard Busse Dagmar Schmidt Helmut Schühlen Roland Thieme Heinz Theres |
| author_facet | Birga Maier Katrin Wagner Steffen Behrens Leonhard Bruch Reinhard Busse Dagmar Schmidt Helmut Schühlen Roland Thieme Heinz Theres |
| author_sort | Birga Maier |
| collection | DOAJ |
| description | Abstract Background Assessment of quality of care in patients with myocardial infarction (MI) should be based on data that effectively enable determination of quality. With the need to simplify measurement techniques, the question arises whether routine data can be used for this purpose. We therefore compared data from a German sickness fund (AOK) with data from the Berlin Myocardial Infarction Registry (BMIR). Methods We included patients hospitalised for treatment of MI in Berlin from 2009-2011. We matched 2305 patients from AOK and BMIR by using deterministic record linkage with indirect identifiers. For matched patients we compared the frequency in documentation between AOK and BMIR for quality assurance variables and calculated the kappa coefficient (KC) as a measure of agreement. Results There was almost perfect agreement in documentation between AOK and BMIR data for matched patients for: catheter laboratory (KC: 0.874), ST elevation MI (KC: 0.826), diabetes (KC: 0.818), percutaneous coronary intervention (KC: 0.860) and hospital mortality (KC: 0.952). The remaining variables compared showed moderate or less than moderate agreement (KC < 0.6), and were grouped in Category II with less frequent documentation in AOK for risk factors and aspects of patients’ history; in Category III with more frequent documentation in AOK for comorbidities; and in Category IV for medication at and after hospital discharge. Conclusions Routine data are primarily collected and defined for reimbursement purposes. Quality assurance represents merely a secondary use. This explains why only a limited number of variables showed almost perfect agreement in documentation between AOK and BMIR. If routine data are to be used for quality assessment, they must be constantly monitored and further developed for this new application. Furthermore, routine data should be complemented with registry data by well-established methods of record linkage to realistically reflect the situation – also for those quality-associated variables not collected in routine data. |
| first_indexed | 2024-12-22T09:48:37Z |
| format | Article |
| id | doaj.art-62f36850593641efbaaa5e33c9fc8e2f |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-22T09:48:37Z |
| publishDate | 2016-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-62f36850593641efbaaa5e33c9fc8e2f2022-12-21T18:30:28ZengBMCBMC Health Services Research1472-69632016-10-011611910.1186/s12913-016-1840-5Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkageBirga Maier0Katrin Wagner1Steffen Behrens2Leonhard Bruch3Reinhard Busse4Dagmar Schmidt5Helmut Schühlen6Roland Thieme7Heinz Theres8Berlin Myocardial Infarction Registry, Technische UniversitätBerlin Myocardial Infarction Registry, Technische UniversitätDepartment of Cardiology, Vivantes Humboldt KlinikumDepartment of Cardiology, Unfallkrankenhaus BerlinDepartment of Health Care Management, Technische UniversitaetDepartment Hospital Affairs, AOK NordostDepartment of Cardiology, Vivantes Auguste-Viktoria-KlinikumDepartment of Cardiology, Jüdisches KrankenhausDepartment of Cardiology, Medical Park Humboldt MuehleAbstract Background Assessment of quality of care in patients with myocardial infarction (MI) should be based on data that effectively enable determination of quality. With the need to simplify measurement techniques, the question arises whether routine data can be used for this purpose. We therefore compared data from a German sickness fund (AOK) with data from the Berlin Myocardial Infarction Registry (BMIR). Methods We included patients hospitalised for treatment of MI in Berlin from 2009-2011. We matched 2305 patients from AOK and BMIR by using deterministic record linkage with indirect identifiers. For matched patients we compared the frequency in documentation between AOK and BMIR for quality assurance variables and calculated the kappa coefficient (KC) as a measure of agreement. Results There was almost perfect agreement in documentation between AOK and BMIR data for matched patients for: catheter laboratory (KC: 0.874), ST elevation MI (KC: 0.826), diabetes (KC: 0.818), percutaneous coronary intervention (KC: 0.860) and hospital mortality (KC: 0.952). The remaining variables compared showed moderate or less than moderate agreement (KC < 0.6), and were grouped in Category II with less frequent documentation in AOK for risk factors and aspects of patients’ history; in Category III with more frequent documentation in AOK for comorbidities; and in Category IV for medication at and after hospital discharge. Conclusions Routine data are primarily collected and defined for reimbursement purposes. Quality assurance represents merely a secondary use. This explains why only a limited number of variables showed almost perfect agreement in documentation between AOK and BMIR. If routine data are to be used for quality assessment, they must be constantly monitored and further developed for this new application. Furthermore, routine data should be complemented with registry data by well-established methods of record linkage to realistically reflect the situation – also for those quality-associated variables not collected in routine data.http://link.springer.com/article/10.1186/s12913-016-1840-5Health services researchRoutine administrative dataQuality of careHospital performanceMyocardial infarction |
| spellingShingle | Birga Maier Katrin Wagner Steffen Behrens Leonhard Bruch Reinhard Busse Dagmar Schmidt Helmut Schühlen Roland Thieme Heinz Theres Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage BMC Health Services Research Health services research Routine administrative data Quality of care Hospital performance Myocardial infarction |
| title | Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage |
| title_full | Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage |
| title_fullStr | Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage |
| title_full_unstemmed | Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage |
| title_short | Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage |
| title_sort | comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage |
| topic | Health services research Routine administrative data Quality of care Hospital performance Myocardial infarction |
| url | http://link.springer.com/article/10.1186/s12913-016-1840-5 |
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