Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management

C. Corbellini, B. Andreoni, L. Ansaloni, G. Sgroi, M. Martinotti, I. Scandroglio, P. Carzaniga, M. Longoni, D. Foschi, P. Dionigi, E. Morandi, M. Agnello, D. Tamayo, E. Botteri, E. Poiasina, C. Azzini, L. Turati, A. Frigerio, F. Roscio, T. D’AponteA. Costanzi, R. Picheo, N. Olivari, F. Trotta, C. Lunghi, M. Francese, M. Stella, C. Beati, E. Motterlini, A. Cirelli, E. Opocher, A.P. Ceretti, G. Dionigi, E. Guffanti, M. Berselli, L. Novellino, P. Mariani, S. Olmi, G. Cesana, M. Montorsi, S. Bona, L. Castelli, D. Coviello, M.A. Guicciardi, A. Favara, M. Crespi, G. Maione, F. Colombo, U. Fumagalli, U. Elmore, L. Boni, S. Costa, P.F. Interdonato, S. Mauri, Lombardy Oncologic Network Work Group

Research output: Contribution to journalArticle

Abstract

Purpose: Measurement and monitoring of the quality of care using a core set of quality measures are increasing in health service research. Although administrative databases include limited clinical data, they offer an attractive source for quality measurement. The purpose of this study, therefore, was to evaluate the completeness of different administrative data sources compared to a clinical survey in evaluating rectal cancer cases. Methods: Between May 2012 and November 2014, a clinical survey was done on 498 Lombardy patients who had rectal cancer and underwent surgical resection. These collected data were compared with the information extracted from administrative sources including Hospital Discharge Dataset, drug database, daycare activity data, fee-exemption database, and regional screening program database. The agreement evaluation was performed using a set of 12 quality indicators. Results: Patient complexity was a difficult indicator to measure for lack of clinical data. Preoperative staging was another suboptimal indicator due to the frequent missing administrative registration of tests performed. The agreement between the 2 data sources regarding chemoradiotherapy treatments was high. Screening detection, minimally invasive techniques, length of stay, and unpreventable readmissions were detected as reliable quality indicators. Postoperative morbidity could be a useful indicator but its agreement was lower, as expected. Conclusions: Healthcare administrative databases are large and real-time collected repositories of data useful in measuring quality in a healthcare system. Our investigation reveals that the reliability of indicators varies between them. Ideally, a combination of data from both sources could be used in order to improve usefulness of less reliable indicators. © Fondazione IRCCS Istituto Nazionale dei Tumori 2017.
Original languageEnglish
Pages (from-to)51-59
Number of pages9
JournalTumori
Volume104
Issue number1
DOIs
Publication statusPublished - 2017

Fingerprint

Rectal Neoplasms
Reproducibility of Results
Information Storage and Retrieval
Databases
Pharmaceutical Databases
Delivery of Health Care
Fees and Charges
Quality of Health Care
Health Services Research
Chemoradiotherapy
Length of Stay
Morbidity
Surveys and Questionnaires
Therapeutics

Keywords

  • Administrative databases
  • Healthcare monitoring
  • Healthcare quality
  • Rectal cancer
  • Surgery quality indicators
  • antineoplastic agent
  • adjuvant radiotherapy
  • Article
  • cancer adjuvant therapy
  • cancer patient
  • cancer staging
  • cancer surgery
  • cancer therapy
  • chemoradiotherapy
  • hospital readmission
  • human
  • length of stay
  • major clinical study
  • minimally invasive surgery
  • postoperative complication
  • rectum cancer
  • factual database
  • health care delivery
  • health care quality
  • health survey
  • Italy
  • primary health care
  • procedures
  • prospective study
  • rectum tumor
  • reproducibility
  • standards
  • statistics and numerical data
  • validation study
  • Databases, Factual
  • Delivery of Health Care
  • Health Surveys
  • Humans
  • Primary Health Care
  • Prospective Studies
  • Quality Indicators, Health Care
  • Rectal Neoplasms
  • Reproducibility of Results

Cite this

Corbellini, C., Andreoni, B., Ansaloni, L., Sgroi, G., Martinotti, M., Scandroglio, I., ... Group, L. O. N. W. (2017). Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management. Tumori, 104(1), 51-59. https://doi.org/10.5301/tj.5000708

Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management. / Corbellini, C.; Andreoni, B.; Ansaloni, L.; Sgroi, G.; Martinotti, M.; Scandroglio, I.; Carzaniga, P.; Longoni, M.; Foschi, D.; Dionigi, P.; Morandi, E.; Agnello, M.; Tamayo, D.; Botteri, E.; Poiasina, E.; Azzini, C.; Turati, L.; Frigerio, A.; Roscio, F.; D’Aponte, T.; Costanzi, A.; Picheo, R.; Olivari, N.; Trotta, F.; Lunghi, C.; Francese, M.; Stella, M.; Beati, C.; Motterlini, E.; Cirelli, A.; Opocher, E.; Ceretti, A.P.; Dionigi, G.; Guffanti, E.; Berselli, M.; Novellino, L.; Mariani, P.; Olmi, S.; Cesana, G.; Montorsi, M.; Bona, S.; Castelli, L.; Coviello, D.; Guicciardi, M.A.; Favara, A.; Crespi, M.; Maione, G.; Colombo, F.; Fumagalli, U.; Elmore, U.; Boni, L.; Costa, S.; Interdonato, P.F.; Mauri, S.; Group, Lombardy Oncologic Network Work.

In: Tumori, Vol. 104, No. 1, 2017, p. 51-59.

Research output: Contribution to journalArticle

Corbellini, C, Andreoni, B, Ansaloni, L, Sgroi, G, Martinotti, M, Scandroglio, I, Carzaniga, P, Longoni, M, Foschi, D, Dionigi, P, Morandi, E, Agnello, M, Tamayo, D, Botteri, E, Poiasina, E, Azzini, C, Turati, L, Frigerio, A, Roscio, F, D’Aponte, T, Costanzi, A, Picheo, R, Olivari, N, Trotta, F, Lunghi, C, Francese, M, Stella, M, Beati, C, Motterlini, E, Cirelli, A, Opocher, E, Ceretti, AP, Dionigi, G, Guffanti, E, Berselli, M, Novellino, L, Mariani, P, Olmi, S, Cesana, G, Montorsi, M, Bona, S, Castelli, L, Coviello, D, Guicciardi, MA, Favara, A, Crespi, M, Maione, G, Colombo, F, Fumagalli, U, Elmore, U, Boni, L, Costa, S, Interdonato, PF, Mauri, S & Group, LONW 2017, 'Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management', Tumori, vol. 104, no. 1, pp. 51-59. https://doi.org/10.5301/tj.5000708
Corbellini C, Andreoni B, Ansaloni L, Sgroi G, Martinotti M, Scandroglio I et al. Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management. Tumori. 2017;104(1):51-59. https://doi.org/10.5301/tj.5000708
Corbellini, C. ; Andreoni, B. ; Ansaloni, L. ; Sgroi, G. ; Martinotti, M. ; Scandroglio, I. ; Carzaniga, P. ; Longoni, M. ; Foschi, D. ; Dionigi, P. ; Morandi, E. ; Agnello, M. ; Tamayo, D. ; Botteri, E. ; Poiasina, E. ; Azzini, C. ; Turati, L. ; Frigerio, A. ; Roscio, F. ; D’Aponte, T. ; Costanzi, A. ; Picheo, R. ; Olivari, N. ; Trotta, F. ; Lunghi, C. ; Francese, M. ; Stella, M. ; Beati, C. ; Motterlini, E. ; Cirelli, A. ; Opocher, E. ; Ceretti, A.P. ; Dionigi, G. ; Guffanti, E. ; Berselli, M. ; Novellino, L. ; Mariani, P. ; Olmi, S. ; Cesana, G. ; Montorsi, M. ; Bona, S. ; Castelli, L. ; Coviello, D. ; Guicciardi, M.A. ; Favara, A. ; Crespi, M. ; Maione, G. ; Colombo, F. ; Fumagalli, U. ; Elmore, U. ; Boni, L. ; Costa, S. ; Interdonato, P.F. ; Mauri, S. ; Group, Lombardy Oncologic Network Work. / Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management. In: Tumori. 2017 ; Vol. 104, No. 1. pp. 51-59.
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title = "Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management",
abstract = "Purpose: Measurement and monitoring of the quality of care using a core set of quality measures are increasing in health service research. Although administrative databases include limited clinical data, they offer an attractive source for quality measurement. The purpose of this study, therefore, was to evaluate the completeness of different administrative data sources compared to a clinical survey in evaluating rectal cancer cases. Methods: Between May 2012 and November 2014, a clinical survey was done on 498 Lombardy patients who had rectal cancer and underwent surgical resection. These collected data were compared with the information extracted from administrative sources including Hospital Discharge Dataset, drug database, daycare activity data, fee-exemption database, and regional screening program database. The agreement evaluation was performed using a set of 12 quality indicators. Results: Patient complexity was a difficult indicator to measure for lack of clinical data. Preoperative staging was another suboptimal indicator due to the frequent missing administrative registration of tests performed. The agreement between the 2 data sources regarding chemoradiotherapy treatments was high. Screening detection, minimally invasive techniques, length of stay, and unpreventable readmissions were detected as reliable quality indicators. Postoperative morbidity could be a useful indicator but its agreement was lower, as expected. Conclusions: Healthcare administrative databases are large and real-time collected repositories of data useful in measuring quality in a healthcare system. Our investigation reveals that the reliability of indicators varies between them. Ideally, a combination of data from both sources could be used in order to improve usefulness of less reliable indicators. {\circledC} Fondazione IRCCS Istituto Nazionale dei Tumori 2017.",
keywords = "Administrative databases, Healthcare monitoring, Healthcare quality, Rectal cancer, Surgery quality indicators, antineoplastic agent, adjuvant radiotherapy, Article, cancer adjuvant therapy, cancer patient, cancer staging, cancer surgery, cancer therapy, chemoradiotherapy, hospital readmission, human, length of stay, major clinical study, minimally invasive surgery, postoperative complication, rectum cancer, factual database, health care delivery, health care quality, health survey, Italy, primary health care, procedures, prospective study, rectum tumor, reproducibility, standards, statistics and numerical data, validation study, Databases, Factual, Delivery of Health Care, Health Surveys, Humans, Primary Health Care, Prospective Studies, Quality Indicators, Health Care, Rectal Neoplasms, Reproducibility of Results",
author = "C. Corbellini and B. Andreoni and L. Ansaloni and G. Sgroi and M. Martinotti and I. Scandroglio and P. Carzaniga and M. Longoni and D. Foschi and P. Dionigi and E. Morandi and M. Agnello and D. Tamayo and E. Botteri and E. Poiasina and C. Azzini and L. Turati and A. Frigerio and F. Roscio and T. D’Aponte and A. Costanzi and R. Picheo and N. Olivari and F. Trotta and C. Lunghi and M. Francese and M. Stella and C. Beati and E. Motterlini and A. Cirelli and E. Opocher and A.P. Ceretti and G. Dionigi and E. Guffanti and M. Berselli and L. Novellino and P. Mariani and S. Olmi and G. Cesana and M. Montorsi and S. Bona and L. Castelli and D. Coviello and M.A. Guicciardi and A. Favara and M. Crespi and G. Maione and F. Colombo and U. Fumagalli and U. Elmore and L. Boni and S. Costa and P.F. Interdonato and S. Mauri and Group, {Lombardy Oncologic Network Work}",
note = "Export Date: 5 February 2019 CODEN: TUMOA Correspondence Address: Corbellini, C.; Ospedale di Rho, ASST Rhodense, Corso Europa, 250, Italy; email: dr.corbellini@gmail.com References: Lohr, K.N., Medicare: A strategy for quality assurance (1991) J Qual Assur, 13 (1), pp. 10-13; Boland, G.M., Chang, G.J., Haynes, A.B., Association between adherence to National Comprehensive Cancer Network treatment guidelines and improved survival in patients with colon cancer (2013) Cancer, 119 (8), pp. 1593-1601; Chagpar, R., Xing, Y., Chiang, Y.J., Adherence to stage-specific treatment guidelines for patients with colon cancer (2012) J Clin Oncol, 30 (9), pp. 972-979; Campbell, S.M., Braspenning, J., Hutchinson, A., Marshall, M., Research methods used in developing and applying quality indicators in primary care (2002) Qual Saf Health Care, 11 (4), pp. 358-364; Morris, A.M., Billingsley, K.G., Baxter, N.N., Baldwin, L.M., Racial disparities in rectal cancer treatment: A population-based analysis (2004) Arch Surg, 139 (2), pp. 151-155. , discussion 156; Porter, G.A., Soskolne, C.L., Yakimets, W.W., Newman, S.C., Surgeon-related factors and outcome in rectal cancer (1998) Ann Surg, 227 (2), pp. 157-167; Egeberg, R., Halkjaer, J., Rottmann, N., Hansen, L., Holten, I., Social inequality and incidence of and survival from cancers of the colon and rectum in a population-based study in Denmark, 19942003 (2008) Eur J Cancer, 44 (14), pp. 1978-1988; Gavrielov-Yusim, N., Friger, M., Use of administrative medical databases in population-based research (2014) J Epidemiol Community Health, 68 (3), pp. 283-287; Hoover, K.W., Tao, G., Kent, C.K., Aral, S.O., Epidemiologic research using administrative databases: Garbage in, garbage out (2011) Obstet Gynecol, 117 (3), pp. 729-730. , author reply 729-730; Yurkovich, M., Avina-Zubieta, J.A., Thomas, J., Gorenchtein, M., Lacaille, D., A systematic review identifies valid comorbidity indices derived from administrative health data (2015) J Clin Epidemiol, 68 (1), pp. 3-14; Donabedian, A., Evaluating the quality of medical care (1966) Milbank Mem Fund Q, 44 (3), pp. 166-206; Birkmeyer, J.D., Dimick, J.B., Birkmeyer, N.J., Measuring the quality of surgical care: Structure, process, or outcomes? (2004) J am Coll Surg, 198 (4), pp. 626-632; http://www.progettorol.it, (Lombardy Oncologic Network guidelines); Byrt, T., Bishop, J., Carlin, J.B., Bias, prevalence and kappa (1993) J Clin Epidemiol, 46 (5), pp. 423-429; Landis, J.R., Koch, G.G., The measurement of observer agreement for categorical data (1977) Biometrics, 33 (1), pp. 159-174; Benchimol, E.I., Manuel, D.G., To, T., Griffiths, A.M., Rabeneck, L., Guttmann, A., Development and use of reporting guidelines for assessing the quality of validation studies of health administrative data (2011) J Clin Epidemiol, 64 (8), pp. 821-829; http://www.who.int/mediacentre/factsheets/fs297/en/; Pucciarelli, S., Chiappetta, A., Giacomazzo, G., Surgical Unit volume and 30-day reoperation rate following primary resection for colorectal cancer in the Veneto Region (Italy) (2016) Tech Coloproctol, 20 (1), pp. 31-40; Snyder, R.A., Mainthia, R., Patel, R., Dittus, R.S., Roumie, C.L., Quality of colorectal cancer care among veterans: A 10-year retrospective cohort (2014) Ann Surg Oncol, 21 (8), pp. 2476-2483; Van Gijn, W., Van De Velde, C., Improving quality of cancer care through surgical audit (2010) Eur J Surg Oncol, 36, pp. S23-S26. , members of the EURECCA consortium; Renzi, C., Sorge, C., Fusco, D., Agabiti, N., Davoli, M., Perucci, C.A., Reporting of quality indicators and improvement in hospital performance: the P.Re.Val (2012) E. Regional Outcome Evaluation Program. 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How Do We Detect Colorectal Cancer in an Equal Access Health Care System? (2016) J Gastrointest Surg, 20 (2), pp. 431-438; Gagne, J.J., Glynn, R.J., Avorn, J., Levin, R., Schneeweiss, S., A combined comorbidity score predicted mortality in elderly patients better than existing scores (2011) J Clin Epidemiol, 64 (7), pp. 749-759; Schneeweiss, S., Wang, P.S., Avorn, J., Glynn, R.J., Improved comorbidity adjustment for predicting mortality in Medicare populations (2003) Health Serv Res, 38 (4), pp. 1103-1120; Elixhauser, A., Steiner, C., Harris, D.R., Coffey, R.M., Comorbidity measures for use with administrative data (1998) Med Care, 36 (1), pp. 8-27; Charlson, M.E., Pompei, P., Ales, K.L., Mackenzie, C.R., A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation (1987) J Chronic Dis, 40 (5), pp. 373-383; Sharabiani, M., Aylin, P., Bottle, A., Systematic review of comorbidity indices for administrative data (2012) Med Care, 50 (12), pp. 1109-1118; Hoeffel, C., Mul{\'e}, S., Laurent, V., Bouch{\'e}, O., Volet, J., Soyer, P., Primary rectal cancer local staging (2014) Diagn Interv Imaging, 95 (5), pp. 485-494; Gamagami, R.A., Liagre, A., Chiotasso, P., Istvan, G., Lazorthes, F., Coloanal anastomosis for distal third rectal cancer: Prospective study of oncologic results (1999) Dis Colon Rectum, 42 (10), pp. 1272-1275; Veldkamp, R., Kuhry, E., Hop, W.C., COlon cancer Laparoscopic or Open Resection Study Group (COLOR). Laparoscopic surgery versus open surgery for colon cancer: Short-term outcomes of a randomised trial (2005) Lancet Oncol, 6 (7), pp. 477-484; Almoudaris, A.M., Clark, S., Vincent, C., Faiz, O., Establishing quality in colorectal surgery (2011) Colorectal Dis, 13 (9), pp. 961-973; Sacks, G.D., Dawes, A.J., Russell, M.M., Evaluation of hospital readmissions in surgical patients: Do administrative data tell the real story? (2014) JAMA Surg, 149 (8), pp. 759-764; Chen, Q., Mull, H.J., Rosen, A.K., Borzecki, A.M., Pilver, C., Itani, K.M., Measuring readmissions after surgery: Do different methods tell the same story? (2016) Am J Surg, 212 (1), pp. 24-33; Williams, J.G., Mann, R.Y., Hospital episode statistics: Time for clinicians to get involved? (2002) Clin Med (Lond), 2 (1), pp. 34-37",
year = "2017",
doi = "10.5301/tj.5000708",
language = "English",
volume = "104",
pages = "51--59",
journal = "Tumori",
issn = "0300-8916",
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}

TY - JOUR

T1 - Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management

AU - Corbellini, C.

AU - Andreoni, B.

AU - Ansaloni, L.

AU - Sgroi, G.

AU - Martinotti, M.

AU - Scandroglio, I.

AU - Carzaniga, P.

AU - Longoni, M.

AU - Foschi, D.

AU - Dionigi, P.

AU - Morandi, E.

AU - Agnello, M.

AU - Tamayo, D.

AU - Botteri, E.

AU - Poiasina, E.

AU - Azzini, C.

AU - Turati, L.

AU - Frigerio, A.

AU - Roscio, F.

AU - D’Aponte, T.

AU - Costanzi, A.

AU - Picheo, R.

AU - Olivari, N.

AU - Trotta, F.

AU - Lunghi, C.

AU - Francese, M.

AU - Stella, M.

AU - Beati, C.

AU - Motterlini, E.

AU - Cirelli, A.

AU - Opocher, E.

AU - Ceretti, A.P.

AU - Dionigi, G.

AU - Guffanti, E.

AU - Berselli, M.

AU - Novellino, L.

AU - Mariani, P.

AU - Olmi, S.

AU - Cesana, G.

AU - Montorsi, M.

AU - Bona, S.

AU - Castelli, L.

AU - Coviello, D.

AU - Guicciardi, M.A.

AU - Favara, A.

AU - Crespi, M.

AU - Maione, G.

AU - Colombo, F.

AU - Fumagalli, U.

AU - Elmore, U.

AU - Boni, L.

AU - Costa, S.

AU - Interdonato, P.F.

AU - Mauri, S.

AU - Group, Lombardy Oncologic Network Work

N1 - Export Date: 5 February 2019 CODEN: TUMOA Correspondence Address: Corbellini, C.; Ospedale di Rho, ASST Rhodense, Corso Europa, 250, Italy; email: dr.corbellini@gmail.com References: Lohr, K.N., Medicare: A strategy for quality assurance (1991) J Qual Assur, 13 (1), pp. 10-13; Boland, G.M., Chang, G.J., Haynes, A.B., Association between adherence to National Comprehensive Cancer Network treatment guidelines and improved survival in patients with colon cancer (2013) Cancer, 119 (8), pp. 1593-1601; Chagpar, R., Xing, Y., Chiang, Y.J., Adherence to stage-specific treatment guidelines for patients with colon cancer (2012) J Clin Oncol, 30 (9), pp. 972-979; Campbell, S.M., Braspenning, J., Hutchinson, A., Marshall, M., Research methods used in developing and applying quality indicators in primary care (2002) Qual Saf Health Care, 11 (4), pp. 358-364; Morris, A.M., Billingsley, K.G., Baxter, N.N., Baldwin, L.M., Racial disparities in rectal cancer treatment: A population-based analysis (2004) Arch Surg, 139 (2), pp. 151-155. , discussion 156; Porter, G.A., Soskolne, C.L., Yakimets, W.W., Newman, S.C., Surgeon-related factors and outcome in rectal cancer (1998) Ann Surg, 227 (2), pp. 157-167; Egeberg, R., Halkjaer, J., Rottmann, N., Hansen, L., Holten, I., Social inequality and incidence of and survival from cancers of the colon and rectum in a population-based study in Denmark, 19942003 (2008) Eur J Cancer, 44 (14), pp. 1978-1988; Gavrielov-Yusim, N., Friger, M., Use of administrative medical databases in population-based research (2014) J Epidemiol Community Health, 68 (3), pp. 283-287; Hoover, K.W., Tao, G., Kent, C.K., Aral, S.O., Epidemiologic research using administrative databases: Garbage in, garbage out (2011) Obstet Gynecol, 117 (3), pp. 729-730. , author reply 729-730; Yurkovich, M., Avina-Zubieta, J.A., Thomas, J., Gorenchtein, M., Lacaille, D., A systematic review identifies valid comorbidity indices derived from administrative health data (2015) J Clin Epidemiol, 68 (1), pp. 3-14; Donabedian, A., Evaluating the quality of medical care (1966) Milbank Mem Fund Q, 44 (3), pp. 166-206; Birkmeyer, J.D., Dimick, J.B., Birkmeyer, N.J., Measuring the quality of surgical care: Structure, process, or outcomes? (2004) J am Coll Surg, 198 (4), pp. 626-632; http://www.progettorol.it, (Lombardy Oncologic Network guidelines); Byrt, T., Bishop, J., Carlin, J.B., Bias, prevalence and kappa (1993) J Clin Epidemiol, 46 (5), pp. 423-429; Landis, J.R., Koch, G.G., The measurement of observer agreement for categorical data (1977) Biometrics, 33 (1), pp. 159-174; Benchimol, E.I., Manuel, D.G., To, T., Griffiths, A.M., Rabeneck, L., Guttmann, A., Development and use of reporting guidelines for assessing the quality of validation studies of health administrative data (2011) J Clin Epidemiol, 64 (8), pp. 821-829; http://www.who.int/mediacentre/factsheets/fs297/en/; Pucciarelli, S., Chiappetta, A., Giacomazzo, G., Surgical Unit volume and 30-day reoperation rate following primary resection for colorectal cancer in the Veneto Region (Italy) (2016) Tech Coloproctol, 20 (1), pp. 31-40; Snyder, R.A., Mainthia, R., Patel, R., Dittus, R.S., Roumie, C.L., Quality of colorectal cancer care among veterans: A 10-year retrospective cohort (2014) Ann Surg Oncol, 21 (8), pp. 2476-2483; Van Gijn, W., Van De Velde, C., Improving quality of cancer care through surgical audit (2010) Eur J Surg Oncol, 36, pp. S23-S26. , members of the EURECCA consortium; Renzi, C., Sorge, C., Fusco, D., Agabiti, N., Davoli, M., Perucci, C.A., Reporting of quality indicators and improvement in hospital performance: the P.Re.Val (2012) E. Regional Outcome Evaluation Program. 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PY - 2017

Y1 - 2017

N2 - Purpose: Measurement and monitoring of the quality of care using a core set of quality measures are increasing in health service research. Although administrative databases include limited clinical data, they offer an attractive source for quality measurement. The purpose of this study, therefore, was to evaluate the completeness of different administrative data sources compared to a clinical survey in evaluating rectal cancer cases. Methods: Between May 2012 and November 2014, a clinical survey was done on 498 Lombardy patients who had rectal cancer and underwent surgical resection. These collected data were compared with the information extracted from administrative sources including Hospital Discharge Dataset, drug database, daycare activity data, fee-exemption database, and regional screening program database. The agreement evaluation was performed using a set of 12 quality indicators. Results: Patient complexity was a difficult indicator to measure for lack of clinical data. Preoperative staging was another suboptimal indicator due to the frequent missing administrative registration of tests performed. The agreement between the 2 data sources regarding chemoradiotherapy treatments was high. Screening detection, minimally invasive techniques, length of stay, and unpreventable readmissions were detected as reliable quality indicators. Postoperative morbidity could be a useful indicator but its agreement was lower, as expected. Conclusions: Healthcare administrative databases are large and real-time collected repositories of data useful in measuring quality in a healthcare system. Our investigation reveals that the reliability of indicators varies between them. Ideally, a combination of data from both sources could be used in order to improve usefulness of less reliable indicators. © Fondazione IRCCS Istituto Nazionale dei Tumori 2017.

AB - Purpose: Measurement and monitoring of the quality of care using a core set of quality measures are increasing in health service research. Although administrative databases include limited clinical data, they offer an attractive source for quality measurement. The purpose of this study, therefore, was to evaluate the completeness of different administrative data sources compared to a clinical survey in evaluating rectal cancer cases. Methods: Between May 2012 and November 2014, a clinical survey was done on 498 Lombardy patients who had rectal cancer and underwent surgical resection. These collected data were compared with the information extracted from administrative sources including Hospital Discharge Dataset, drug database, daycare activity data, fee-exemption database, and regional screening program database. The agreement evaluation was performed using a set of 12 quality indicators. Results: Patient complexity was a difficult indicator to measure for lack of clinical data. Preoperative staging was another suboptimal indicator due to the frequent missing administrative registration of tests performed. The agreement between the 2 data sources regarding chemoradiotherapy treatments was high. Screening detection, minimally invasive techniques, length of stay, and unpreventable readmissions were detected as reliable quality indicators. Postoperative morbidity could be a useful indicator but its agreement was lower, as expected. Conclusions: Healthcare administrative databases are large and real-time collected repositories of data useful in measuring quality in a healthcare system. Our investigation reveals that the reliability of indicators varies between them. Ideally, a combination of data from both sources could be used in order to improve usefulness of less reliable indicators. © Fondazione IRCCS Istituto Nazionale dei Tumori 2017.

KW - Administrative databases

KW - Healthcare monitoring

KW - Healthcare quality

KW - Rectal cancer

KW - Surgery quality indicators

KW - antineoplastic agent

KW - adjuvant radiotherapy

KW - Article

KW - cancer adjuvant therapy

KW - cancer patient

KW - cancer staging

KW - cancer surgery

KW - cancer therapy

KW - chemoradiotherapy

KW - hospital readmission

KW - human

KW - length of stay

KW - major clinical study

KW - minimally invasive surgery

KW - postoperative complication

KW - rectum cancer

KW - factual database

KW - health care delivery

KW - health care quality

KW - health survey

KW - Italy

KW - primary health care

KW - procedures

KW - prospective study

KW - rectum tumor

KW - reproducibility

KW - standards

KW - statistics and numerical data

KW - validation study

KW - Databases, Factual

KW - Delivery of Health Care

KW - Health Surveys

KW - Humans

KW - Primary Health Care

KW - Prospective Studies

KW - Quality Indicators, Health Care

KW - Rectal Neoplasms

KW - Reproducibility of Results

U2 - 10.5301/tj.5000708

DO - 10.5301/tj.5000708

M3 - Article

VL - 104

SP - 51

EP - 59

JO - Tumori

JF - Tumori

SN - 0300-8916

IS - 1

ER -