Use of Paper Medical Records Versus Administrative Data for Measuring and Improving Health Care Quality: Are We Still Searching for a Gold Standard?

Diamond, Carol C.; Rask, Kimberly J.; Kohler, Susan A.

doi:10.1089/10935070152596043

Cited by 11 publications

(9 citation statements)

References 30 publications

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“…We feel that this type of bias would have a minimal effect upon our results as prior works have demonstrated that administrative claims are reliable when studying procedures that are highly linked to reimbursement, such as diagnostic testing, and are comparable to data found in medical records. (44–46)…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Ionizing Radiation Exposure in a Population-Based Sample of Children With Inflammatory Bowel Diseases

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Diagnostic Ionizing Radiation Exposure in a Population-Based Sample of Children With Inflammatory Bowel Diseases

et al. 2009

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“…Fowles et al (1997) found Papanicolaou smear data from the 2 sources to be in concordance, and Diamond et al (2001) reported administrative claims data to be more accurate in identifying completed Papanicolaou smears and mammograms. Conversely, billing claims data have been shown to significantly underestimate mammography usage (Mouchawar et al, 2004) and diabetes screening (Maclean et al, 2002) in comparison with MRR in other studies.…”

mentioning

confidence: 90%

Comparison of Provider Claims Data Versus Medical Records Review for Assessing Provision of Adult Preventive Services

Naessens¹,

Ruud²,

Tulledge–Scheitel³

et al. 2008

Journal of Ambulatory Care Management

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Administrative claims data are often used to assess the delivery of preventive services, yet there are important limitations. This study assessed the use of claims data to measure quality for pay-for-performance and as a preventive services screening tool compared with medical records review. Accuracy and bias in relying on claims data from a provider perspective were investigated, including a comparison of practice types. Claims data consistently underestimated the rate of preventive services, but the type of practice influenced accuracy. Claims data should be used cautiously, if at all, for pay for performance or to trigger reminders for preventive services completion.

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“…Their billing and administrative databases contain cancer-screening information that can effi ciently identify patients needing services and evaluate whether services are subsequently obtained. Claims-based screening data can be more accurate than both medical records 16,17 and patient self-report. 18 In addition, many MMCOs use sophisticated customer relations management software and have experienced staff who can provide telephone outreach to members, an essential component of the PCM intervention.…”

Section: Ancer Scr Eening In a N Mmcomentioning

confidence: 99%

mentioning

confidence: 99%

Translation of an Efficacious Cancer-Screening Intervention to Women Enrolled in a Medicaid Managed Care Organization

Dietrich¹,

Tobin²,

Cassells³

et al. 2007

The Annals of Family Medicine

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PURPOSE An earlier randomized controlled trial of prevention care management (PCM) found signifi cant improvement in breast, cervical, and colorectal cancerscreening rates among women attending Community Health Centers but required substantial research support. This study evaluated the impact of a streamlined PCM delivered through a Medicaid managed care organization (MMCO), an infrastructure with the potential to sustain this program for the long term. METHODS This randomized trial was conducted within an MMCO serving NewYork City between May 2005 and December 2005. A total of 1,316 women aged 40 to 69 years and not up to date for at least 1 targeted cancer-screening test were randomized to either PCM or a comparison group. Women in the PCM group received up to 3 scripted telephone calls to identify barriers and provide support to obtain any needed breast, cervical, and colorectal cancer-screening tests. Women in the comparison group received a modifi ed version of the MMCO's established mammography telephone outreach program, also in up to 3 calls. Women in both groups received a fi nancial incentive on confi rmation that they had received a mammogram. Screening status was assessed through MMCO administrative data. Groups were compared using odds ratios. RESULTSIn an intent-to-treat comparison adjusted for baseline screening status, PCM women were 1.69 times more likely to be up-to-date for colorectal cancerscreening tests at follow-up than women in the comparison group (95% confidence interval, 1.03-2.77). Follow-up screening rates for cervical and breast cancer did not differ signifi cantly between study groups on an intent-to-treat basis. CONCLUSIONSThe abbreviated PCM telephone intervention was feasible to deliver through an MMCO and improved screening for 1 cancer. This approach has the potential to improve cancer-screening rates signifi cantly in settings that can provide telephone support to women known to be overdue. 2007;5:320-327. DOI: 10.1370/afm.701. Ann Fam Med INTRODUCTIONL ower cancer-screening rates among low-income and minority women may contribute to more late-stage diagnoses and higher rates of cancer mortality. [1][2][3][4][5][6] Although socioeconomic variables such as income and education may explain much of the disparity in cancer screening observed between racial and ethnic groups, 2,7,8 disparities nonetheless remain. Recent surveys in New York City found that Hispanics and African Americans were less likely to be screened for colorectal cancer than whites, 9,10 and cancer mortality rates were 1.3 times higher among residents living in low-income areas than among their counterparts in higher-income areas. 11A previously reported randomized controlled trial of a prevention care management (PCM) intervention found an improvement in cancer- 12 PCM is a telephone-based intervention delivered by trained staff to women who were not up-to-date for breast, cervical, or colorectal cancer screening, to help them overcome barriers to receiving needed tests. The intervention signifi cantly...

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Use of Paper Medical Records Versus Administrative Data for Measuring and Improving Health Care Quality: Are We Still Searching for a Gold Standard?

Cited by 11 publications

References 30 publications

Diagnostic Ionizing Radiation Exposure in a Population-Based Sample of Children With Inflammatory Bowel Diseases

Diagnostic Ionizing Radiation Exposure in a Population-Based Sample of Children With Inflammatory Bowel Diseases

Comparison of Provider Claims Data Versus Medical Records Review for Assessing Provision of Adult Preventive Services

Translation of an Efficacious Cancer-Screening Intervention to Women Enrolled in a Medicaid Managed Care Organization

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