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Assessing data quality: a computerized approach.

https://arctichealth.org/en/permalink/ahliterature231412
Source
Soc Sci Med. 1989;28(2):175-82
Publication Type
Article
Date
1989
Author
L L Roos
S M Sharp
A. Wajda
Author Affiliation
Faculty of Management, University of Manitoba, Winnipeg, Canada.
Source
Soc Sci Med. 1989;28(2):175-82
Date
1989
Language
English
Publication Type
Article
Keywords
Data Collection - standards
Database Management Systems
Hospital records
Humans
Manitoba
Medical Records
Software
Abstract
With the growing reliance on large health care data bases, the need to verify data quality increases as well. Because of the considerable costs involved in checks using primary data collection, a computerized methodology for performing such checks is suggested. The technique seems appropriate for any situation where two data collection systems (i.e. hospital discharge abstracts and physician claims for payment) relate to the same event, such as a patient's hospitalization. After reviewing other approaches, this paper suggests linking physician claims for performing particular surgical procedures with hospital discharge abstracts for the stay in which the surgery took place. Physician and hospital data for adults age 25 and over in Manitoba from 1 April, 1979 to 31 March, 1984 were used to address the questions: 1. How well can the two data sets be linked? 2. Given linkage of the two data sets, how much agreement is there as to procedure and diagnosis? Linkage between hospital and physician data was excellent (over 95%) for 5 out of 11 surgical procedures (hysterectomy, prostatectomy, total hip replacement, coronary artery bypass surgery, and heart valve replacement); there was over 90% perfect agreement for three other procedures (cholecystectomy, cataract surgery and total knee replacement). Problems with matching the Manitoba Health Services Commission tariffs (on physician claims) with ICD-9-CM operation codes (on hospital data) led to only 77% perfect agreement for vascular surgery and 84% for gallbladder and biliary tract operations other than cholecystectomy; over 10% of the cases linked on surgeon and date but not on the designated procedures.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
2928827 View in PubMed
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Becoming more efficient at outcomes research.

https://arctichealth.org/en/permalink/ahliterature234342
Source
Int J Technol Assess Health Care. 1988;4(4):555-71
Publication Type
Article
Date
1988
Author
L L Roos
S M Sharp
Source
Int J Technol Assess Health Care. 1988;4(4):555-71
Date
1988
Language
English
Publication Type
Article
Keywords
Cholecystectomy - adverse effects - standards
Humans
Manitoba
Models, Theoretical
Outcome and Process Assessment (Health Care) - methods
Patient Readmission
Regression Analysis
Research Design
Technology Assessment, Biomedical - methods
Abstract
This paper discusses several practical problems in research design: Is it worth doing a relatively "quick and dirty" study or is a more thorough study using all available information necessary? All the desired information may either not be available or be time-consuming to collect. What are the likely biases in going ahead and doing the research with the data base "in hand"? Such issues are important because of the limited resources for technology assessment (in terms of money, number of researchers, and research interest) and the great number of unstudied technologies.
PubMed ID
10291099 View in PubMed
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Comparing clinical information with claims data: some similarities and differences.

https://arctichealth.org/en/permalink/ahliterature227258
Source
J Clin Epidemiol. 1991;44(9):881-8
Publication Type
Article
Date
1991
Author
L L Roos
S M Sharp
M M Cohen
Author Affiliation
Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
Source
J Clin Epidemiol. 1991;44(9):881-8
Date
1991
Language
English
Publication Type
Article
Keywords
Anesthesiology
Cardiovascular Diseases - epidemiology
Cholecystectomy - statistics & numerical data
Comorbidity
Data Collection - standards
Forecasting
Health status
Hospitals, Teaching - utilization
Humans
Insurance Claim Reporting - standards
Male
Manitoba - epidemiology
Medical Records - standards
Metabolic Diseases - epidemiology
Outcome and Process Assessment (Health Care) - statistics & numerical data
Patient Readmission - statistics & numerical data
Prospective Studies
Prostatectomy - statistics & numerical data
Respiration Disorders - epidemiology
Retrospective Studies
Abstract
How well can hospital discharge abstracts be used to estimate patient health status? This paper compares information on comorbidity obtained from hospital discharge abstracts for patients undergoing prostatectomy or cholecystectomy at a Winnipeg teaching hospital with clinical data on preoperative medical conditions prospectively collected during an Anesthesia Follow-up study. The diagnostic information on cardiovascular disease, respiratory disease, and metabolic disorders showed considerable agreement, ranging from 65 to over 90% correspondence across the two data sets. Certain conditions noted by the anesthesiologist were often absent from the claims data; cardiovascular disease was recorded in the clinical data but absent from the claims for 31% of prostatectomy and 17% of cholecystectomy cases. Such patients were less likely to have been assigned a high score on the ASA Physical Status measure or to have high-risk diagnoses on the hospital file. Similar findings resulted from comparing the two sources in their ability to predict such adverse outcomes as mortality and readmission to hospital: the anesthesia file generally included less serious comorbidity.
Notes
Comment In: J Clin Epidemiol. 1991;44(9):867-91890429
PubMed ID
1890430 View in PubMed
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Innovation, centralization, and growth. Coronary artery bypass graft surgery in Manitoba.

https://arctichealth.org/en/permalink/ahliterature230820
Source
Med Care. 1989 May;27(5):441-52
Publication Type
Article
Date
May-1989
Author
L L Roos
S M Sharp
Author Affiliation
Faculty of Management, University of Manitoba, Winnipeg, Canada.
Source
Med Care. 1989 May;27(5):441-52
Date
May-1989
Language
English
Publication Type
Article
Keywords
Adult
Aged
Angiography - utilization
Coronary Angiography
Coronary Artery Bypass - trends - utilization
Female
Heart Valves - surgery
Hospitalization - trends
Humans
Male
Manitoba
Middle Aged
Myocardial Infarction - mortality
Referral and Consultation
Abstract
Innovation and diffusion of new surgical procedures are limited in Manitoba, Canada by restrictions on which hospitals are allowed to perform particular surgical programs. Programs centralizing performance of certain operations in a few hospitals have the potential for controlling costs and quality of care but may limit access for individuals living in other areas. Such issues are highlighted in this analysis of coronary artery bypass graft surgery in Manitoba. Patterns of growth and access are first examined; then regional variations in rates of bypass surgery are compared with rates for coronary angiography and valve surgery. Physician reluctance to refer patients to Winnipeg appears to be responsible for the lower rates of these procedures in Western Manitoba. The implications for studies of centralization/regionalization of medical services, physician decision-making, and diffusion of technology are explored.
PubMed ID
2786119 View in PubMed
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Monitoring adverse outcomes of surgery using administrative data.

https://arctichealth.org/en/permalink/ahliterature234465
Source
Health Care Financ Rev. 1987 Dec;Spec No:5-16
Publication Type
Article
Date
Dec-1987
Author
L L Roos
N P Roos
S M Sharp
Source
Health Care Financ Rev. 1987 Dec;Spec No:5-16
Date
Dec-1987
Language
English
Publication Type
Article
Keywords
Cholecystectomy - adverse effects - mortality
Data Collection
Female
Hospital Departments - standards
Humans
Hysterectomy - adverse effects - mortality
Male
Manitoba
Mortality
Outcome and Process Assessment (Health Care) - methods
Patient Readmission
Prostatectomy - adverse effects - mortality
Statistics as Topic
Surgery Department, Hospital - standards
Abstract
In this article, we document a stabilization in adverse outcomes associated with hysterectomies, cholecystectomies, and prostatectomies performed between 1972-73 and 1982-83 in Manitoba, Canada. The proportion of surgery performed by high-volume surgeons and by surgical specialists increased slightly over the decade. However, given the already low rates of adverse outcomes, these changes did not translate into significant decreases in the postoperative mortality rate or in the rate of related hospital readmissions. Reducing the proportion of adverse outcomes would be facilitated by identifying institutions with poorer than expected outcomes.
PubMed ID
10312320 View in PubMed
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Postsurgical mortality in Manitoba and New England.

https://arctichealth.org/en/permalink/ahliterature229087
Source
JAMA. 1990 May 9;263(18):2453-8
Publication Type
Article
Date
May-9-1990
Author
L L Roos
E S Fisher
S M Sharp
J P Newhouse
G. Anderson
T A Bubolz
Author Affiliation
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
Source
JAMA. 1990 May 9;263(18):2453-8
Date
May-9-1990
Language
English
Publication Type
Article
Keywords
Aged
Female
Hospital Departments - statistics & numerical data
Humans
Insurance, Health - statistics & numerical data
Logistic Models
Male
Manitoba - epidemiology
New England - epidemiology
Patient Discharge - statistics & numerical data
Surgical Procedures, Operative - mortality - statistics & numerical data
Survival Rate
Abstract
Per capita hospital expenditures in the United States exceed those in Canada, but little research has examined differences in outcomes. We used insurance databases to compare postsurgical mortality for 11 specific surgical procedures, both before and after adjustment for case mix, among residents of New England and Manitoba who were over 65 years of age. For low- and moderate-risk procedures, 30-day mortality rates were similar in both regions, but 6-month mortality rates were lower in Manitoba. For the two high-risk procedures, concurrent coronary bypass/valve replacement and hip fracture repair, both 30-day and 6-month mortality rates were lower in New England. Although no consistent pattern favoring New England for cardiovascular surgery was found, the increased mortality following hip fracture in Manitoba was found for all types of repair and all age groups. We conclude that for low- and moderate-risk procedures, the higher hospital expenditures in New England were not associated with lower perioperative mortality rates.
PubMed ID
2329632 View in PubMed
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Risk adjustment in claims-based research: the search for efficient approaches.

https://arctichealth.org/en/permalink/ahliterature231782
Source
J Clin Epidemiol. 1989;42(12):1193-206
Publication Type
Article
Date
1989
Author
L L Roos
S M Sharp
M M Cohen
A. Wajda
Author Affiliation
Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
Source
J Clin Epidemiol. 1989;42(12):1193-206
Date
1989
Language
English
Publication Type
Article
Keywords
Comorbidity
Female
Humans
Insurance Claim Review
Insurance, Health
Longitudinal Studies
Male
Manitoba
Medical Records
Patient Readmission
Postoperative Complications - mortality
Regression Analysis
Risk factors
Severity of Illness Index
Abstract
Claims-based indices of comorbidity and severity, as well as other measures derived from routinely collected administrative data, are developed and tested. The extent to which risk adjustments using claims can be improved by adding information from one well-known measure based on chart review and patient examination (the American Society of Anesthesiologists' (ASA) Physical Status score) is also examined. Readmissions and mortality after three common surgical procedures are the outcomes studied using multiple logistic regression. Claims-based measures of comorbidity, derived both from hospital discharge abstracts at the time of surgery and from hospitalizations in the 6 months before surgery, provided reasonably good predictions of postsurgical readmissions and mortality. In the most complete logistic regression models, the Somers' Dyx measure of fit (a rank correlation coefficient) ranged from 0.23 to 0.38 for readmissions and from 0.46 to 0.72 for mortality. In 5 out of 6 cases, these predictions were not improved by including the prospectively-collected ASA Physical Status score. Such difficulties in improving risk adjustment by more intensive data collection are discussed in terms of their research implications.
PubMed ID
2585010 View in PubMed
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8 records – page 1 of 1.