NDLI: Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage

Content Provider	Springer Nature : BioMed Central
Author	Maier, Birga Wagner, Katrin Behrens, Steffen Bruch, Leonhard Busse, Reinhard Schmidt, Dagmar Schühlen, Helmut Thieme, Roland Theres, Heinz
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.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-016-1840-5.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-016-1840-5
Journal	BMC Health Services Research
Issue Number	1
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2016-10-21
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Health services research Routine administrative data Quality of care Hospital performance Myocardial infarction
Content Type	Text
Resource Type	Article
Subject	Health Policy

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