Using routine comparative data to assess the quality of health care: understanding and avoiding common pitfalls

Powell, Alison; Davies, H. T. O.; Thomson, Richard

doi:10.1136/qhc.12.2.122

Cited by 188 publications

(152 citation statements)

References 54 publications

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“…In particular, the aggregation of statewide administrative data (morbidity) can be problematic because data collection and recording techniques may not have been consistent, and data entry personnel and methods of disease classification may have Other Topics changed over time. 30 The response rate of the majority of studies that estimated the prevalence of risk factors associated with CVD was more than 70%, which is a satisfactory response rate. Some studies used objective 20,22 methods to measure biomedical risk factors for CVD while others used subjective methods.…”

Section: Study Qualitymentioning

confidence: 97%

Are immigrants at risk of heart disease in Australia? A systematic review

Dassanayake¹,

Dharmage²,

Gurrin³

et al. 2009

Aust. Health Review

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We systematically reviewed the peer-reviewed literature to establish the prevalence of cardiovascular disease (CVD) among immigrants in Australia and whether being an immigrant is a CVD risk factor. Of 23 studies identified, 12 were included. Higher prevalence of CVD was found among Middle Eastern, South Asian and some European immigrants. Higher prevalence of CVD risk factors was found among Middle Eastern and Southern European immigrants. Higher alcohol consumption was found among immigrants from New Zealand, the United Kingdom and Ireland. Smoking and physical inactivity were highly preva- THE OVERALL PREVALENCE, morbidity, mortality and risk factors of cardiovascular disease (CVD) 1 vary among ethnic groups due to a range of factors. 2,3 These factors include subgroup of origin, birthplace, age, socioeconomic status, education, culture, and genetic composition. 4 In addition, fluency in English and job and life satisfaction in Australia have also been associated with CVD risk. 5 Previous international literature on the relationship between patterns of CVD and immigrant subgroup has explored the prevalence of CVD morbidity, mortality and risk factors among migrants from a range of countries and regions/continents such as Japan,

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Section: Study Qualitymentioning

confidence: 97%

Are immigrants at risk of heart disease in Australia? A systematic review

Dassanayake¹,

Dharmage²,

Gurrin³

et al. 2009

Aust. Health Review

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“…Databases such as the MBDS also have clear advantages (35). The data collected are usually completed in most hospital admissions and, as they include virtually all cases, provide reasonably accurate estimates of the incidence, prevalence, comorbidity, and mortality of diseases treated 1 Neither alcoholic gastritis nor excess blood alcohol level are included because there were no registered cases of either among patients with celiac disease.…”

Section: Discussionmentioning

confidence: 99%

Celiac disease and alcohol use disorders: increased length of hospital stay, overexpenditures and attributable mortality

Gili

Béjar

Ramírez

et al. 2013

Rev. esp. enferm. dig.

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Background and objectives: alcohol use disorders are associated with a greater incidence of certain comorbidities in patients with celiac disease. Currently there is no available information about the impact that these disorders may have on length of hospital stays, overexpenditures during hospital stays, and excess mortality in these patients.Methods: a case-control study was conducted with a selection of patients 18 years and older hospitalized during 2008-2010 in 87 hospitals in Spain. Estimations of excess length of stays, costs, and attributable mortality were calculated using a multivariate analysis of covariance, which included age, gender, hospital group, alcohol use disorders, tobacco related disease and 30 other comorbidities.Results: patients who had both celiac disease and alcohol use disorders had an increased length of hospital stay, an average of 3.1 days longer in women, and 1.7 days longer in men. Excess costs per stay ranged from 838.7 euros in female patients, to 389.1 euros in male patients. Excess attributable mortality was 15.1 % in women, 12.2 % in men.Conclusions: apart from a gluten-free diet and other medical measures, the prevention of alcohol abuse is indicated in these patients. Patients hospitalized who present these disorders should receive specialized attention after leaving the hospital. Early detection and treatment should be used to prevent the appearance of organic lesions and should not be solely focused on male patients.

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“…Dialysis facility errors in the collection and coding of Form CMS-2728 increase as data collection conflicts with other patient care priorities, as many individuals become involved in the collection process, and due to a host of other situational stimuli that increase the risk of mistakes and inconsistencies. 25 Future research may find that the accuracy of Form CMS-2728 data, as a potential indicator of clinical performance, can inform facility-level quality improvement efforts. 25 In sum, although lacking the sensitivity and specificity of claims data, Form CMS-2728 remains extremely valuable.…”

Section: Discussionmentioning

confidence: 99%

“…25 Future research may find that the accuracy of Form CMS-2728 data, as a potential indicator of clinical performance, can inform facility-level quality improvement efforts. 25 In sum, although lacking the sensitivity and specificity of claims data, Form CMS-2728 remains extremely valuable. The use of Form CMS-2728 is legally mandated to assess patient Medicare eligibility, it provides an overarching picture of patient status at initiation of renal replacement therapy, and the form undergoes regular updating and refinement to buttress the quality of data obtained.…”

Section: Discussionmentioning

confidence: 99%

Form CMS-2728 Data Versus Erythropoietin Claims Data: Implications for Quality of Care Studies

et al. 2012

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Medical Evidence Report Form CMS-2728 data is frequently used to study US dialysis patients, but the validity of these data have been called into question. We compared predialysis erythropoietin use as recorded on Form CMS-2728 with claims data as part of an assessment of quality of care among hemodialysis patients. Medicare claims were linked to Form CMS-2728 data for 18,870 patients. Dialysis patients, 67 years old or older, who started dialysis from 1 June 2005 to 31 May 2007 were eligible. Logistic and multivariate regressions were used to compare the use of either Form CMS-2728 or the corresponding claims data to predict mortality and the probability of meeting target hemoglobin levels. The sensitivity, specificity, and kappa coefficient for the predialysis erythropoietin indicator were 58.0%, 78.4%, and 0.36, respectively. Patients with a predialysis erythropoietin claim were less likely to die compared with patients without a claim (odds ratio ¼ 0.80 and 95% confidence interval ¼ 0.74-0.87), but there was no relationship observed between predialysis care and death using only Form CMS-2728 predictors. At the facility level, a predialysis erythropoietin claim was associated with a 0.085 increase in the rate of meeting target hemoglobin levels compared with patients without a claim (p ¼ 0.041), but no statistically significant relationship was observed when using the Form CMS-2728 indicators. The agreement between Form CMS-2728 and claims data is poor and discordant results are observed when comparing the use of these data sources to predict health outcomes. Facilities with higher agreement between the two data sources may provide greater quality of care.

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Using routine comparative data to assess the quality of health care: understanding and avoiding common pitfalls

Cited by 188 publications

References 54 publications

Are immigrants at risk of heart disease in Australia? A systematic review

Are immigrants at risk of heart disease in Australia? A systematic review

Celiac disease and alcohol use disorders: increased length of hospital stay, overexpenditures and attributable mortality

Form CMS-2728 Data Versus Erythropoietin Claims Data: Implications for Quality of Care Studies

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