Department of Healthcare Policy and Research, School of Medicine, Cancer Prevention and Control, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298-0203, USA.
Health Serv Res. 2010 Oct;45(5 Pt 2):1468-88. doi: 10.1111/j.1475-6773.2010.01142.x. Epub 2010 Aug 2.
Research on pressing health services and policy issues requires access to complete, accurate, and timely patient and organizational data.
This paper describes how administrative and health records (including electronic medical records) can be linked for comparative effectiveness and health services research.
We categorize the major agents (i.e., who owns and controls data and who carries out the data linkage) into three areas: (1) individual investigators; (2) government sponsored linked data bases; and (3) public-private partnerships that facilitate linkage of data owned by private organizations. We describe challenges that may be encountered in the linkage process, and the benefits of combining secondary databases with primary qualitative and quantitative sources. We use cancer care research to illustrate our points.
To fill the gaps in the existing data infrastructure, additional steps are required to foster collaboration among institutions, researchers, and public and private components of the health care sector. Without such effort, independent researchers, governmental agencies, and nonprofit organizations are likely to continue building upon a fragmented and costly system with limited access. Discussion. Without the development and support for emerging information technologies across multiple health care settings, the potential for data collected for clinical and transactional purposes to benefit the research community and, ultimately, the patient population may go unrealized.
The current environment is characterized by budget and technical challenges, but investments in data infrastructure are arguably cost-effective given the need to reform our health care system and to monitor the impact of health reform initiatives.
研究紧迫的卫生服务和政策问题需要获取完整、准确和及时的患者和组织数据。
本文描述了如何将行政和健康记录(包括电子病历)链接起来,以进行比较有效性和卫生服务研究。
我们将主要代理(即,谁拥有和控制数据以及谁进行数据链接)分为三个领域:(1)个体研究人员;(2)政府赞助的链接数据库;以及(3)促进私人组织拥有的数据链接的公私合作伙伴关系。我们描述了链接过程中可能遇到的挑战,以及将二级数据库与主要定性和定量来源相结合的好处。我们使用癌症护理研究来说明我们的观点。
为了填补现有数据基础设施的空白,需要采取额外的步骤来促进机构、研究人员以及卫生保健部门的公共和私营部门之间的合作。如果不这样做,独立研究人员、政府机构和非营利组织可能会继续在一个支离破碎且成本高昂的系统上进行建设,而该系统的访问权限有限。讨论。如果没有在多个医疗保健环境中开发和支持新兴信息技术,那么为临床和交易目的而收集的数据为研究界,最终为患者群体带来好处的潜力可能无法实现。
当前的环境具有预算和技术挑战的特点,但鉴于需要改革我们的医疗保健系统并监测医疗改革举措的影响,对数据基础设施进行投资是具有成本效益的。