Gribben B, Coster G, Pringle M, Simon J
Department of General Practice and Primary Health Care, University of Auckland.
N Z Med J. 2001 Feb 9;114(1125):30-2.
To develop non-invasive methods of measuring the quality of data recorded in general practice.
Laboratory and pharmaceutical claims data from fourteen practices (44 doctors) from the FirstHealth network of general practices were examined to determine the extent to which valid minimum bounds on expected rates of diagnosis coding could be established. These were compared with recorded rates in patient notes to measure completeness of diagnosis recording. Data completeness was measured for demographic data and a marker for the accuracy of gender coding was developed from diagnosis data.
Minimum rates of diagnosis could be established for asthma, diabetes (NIDDM and IDDM), ischaemic heart disease, hypothyroidism, bipolar affective disorder and Parkinson's disease. Minimum bounds for the number of patients requiring monitoring of warfarin and digoxin levels were also established. These expected minimum rates were combined with measures of completeness of age, gender, ethnicity and smoking data, and a gender coding accuracy measure, to produce a set of fourteen data quality indicators. Pass/fail thresholds on each indicator were set and each of the fourteen practices was scored on the number of passes they achieved. The scores ranged from three to nine out of fourteen passses.
Non-invasive data quality measures may be useful in providing feedback to general practitioners as part of a data quality improvement cycle. The sensitivity of this method will decline as data quality improves.
开发测量全科医疗中所记录数据质量的非侵入性方法。
对来自FirstHealth全科医疗网络中14家诊所(44名医生)的实验室和药品报销数据进行检查,以确定能在多大程度上确立诊断编码预期率的有效最低界限。将这些界限与病历中记录的比率进行比较,以衡量诊断记录的完整性。对人口统计学数据的完整性进行了测量,并从诊断数据中开发了一个性别编码准确性的指标。
可以确立哮喘、糖尿病(非胰岛素依赖型糖尿病和胰岛素依赖型糖尿病)、缺血性心脏病、甲状腺功能减退症、双相情感障碍和帕金森病的最低诊断率。还确立了需要监测华法林和地高辛水平的患者数量的最低界限。这些预期最低率与年龄、性别、种族和吸烟数据的完整性测量以及性别编码准确性测量相结合,产生了一组14个数据质量指标。设定了每个指标的通过/不通过阈值,并根据每家诊所通过的指标数量对这14家诊所进行评分。分数范围为14项通过指标中的3至9项。
作为数据质量改进周期的一部分,非侵入性数据质量测量可能有助于向全科医生提供反馈。随着数据质量的提高,该方法的敏感性将下降。