Kostuj T, Smektala R
Abteilung für Unfallchirurgie und Orthopädie, Knappschaftskrankenhaus Bochum-Langendreer, Klinikum der Ruhr-Universität Bochum.
Unfallchirurg. 2010 Dec;113(12):1047-8, 1050-2. doi: 10.1007/s00113-010-1875-8.
Health service quality in Germany can be shown by the data from the external quality assurance program (BQS) but as these records are limited to the period of in-hospital stay no information about outcome after discharge from hospital can be obtained. Secondary routine administrative data contain information about long-term outcome, such as mortality, subsequent revision and the need for care following surgical treatment due to a hip fracture.Experiences in the use of secondary data dealing with treatment of hip fractures from the BQS are available in our department. In addition we analyzed routine administrative data from the health insurance companies Knappschaft Bahn-See and AOK in a cooperative study with the WidO (scientific institute of the AOK). These routine data clearly show a bias because of poor quality in coding as well as broad interpretation possibilities of some of the ICD-10 codes used.Consequently quality assurance using routine data is less valid than register-based conclusions. Nevertheless medical expertise is necessary to avoid misinterpretation of routine administrative data.
德国医疗服务质量可通过外部质量保证计划（BQS）的数据来体现，但由于这些记录仅限于住院期间，因此无法获取出院后结果的信息。二级常规管理数据包含有关长期结果的信息，例如死亡率、后续翻修以及髋部骨折手术后的护理需求。我们科室有使用BQS中处理髋部骨折治疗的二级数据的经验。此外，我们在与WidO（AOK的科研机构）的合作研究中，分析了健康保险公司Knappschaft Bahn-See和AOK的常规管理数据。这些常规数据由于编码质量差以及所使用的一些ICD-10代码的广泛解释可能性，明显显示出偏差。因此，使用常规数据进行质量保证不如基于登记的结论有效。尽管如此，仍需要医学专业知识来避免对常规管理数据的错误解读。
