Kuehl Damon R, Berdahl Carl T, Jackson Tiffany D, Venkatesh Arjun K, Mistry Rakesh D, Bhargavan-Chatfield Mythreyi, Raukar Neha P, Carr Brendan G, Schuur Jeremiah D, Kocher Keith E
Department of Emergency Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA.
Department of Emergency Medicine, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA.
Acad Emerg Med. 2015 Dec;22(12):1417-26. doi: 10.1111/acem.12827. Epub 2015 Nov 17.
Administrative data are critical to describing patterns of use, cost, and appropriateness of imaging in emergency care. These data encompass a range of source materials that have been collected primarily for a nonresearch use: documenting clinical care (e.g., medical records), administering care (e.g., picture archiving and communication systems), or financial transactions (e.g., insurance claims). These data have served as the foundation for large, descriptive studies that have documented the rise and expanded role of diagnostic imaging in the emergency department (ED). This article summarizes the discussions of the breakout session on the use of administrative data for emergency imaging research at the May 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The authors describe the areas where administrative data have been applied to research evaluating the use of diagnostic imaging in the ED, the common sources for these data, and the strengths and limitations of administrative data. Next, the future role of administrative data is examined for answering key research questions in an evolving health system increasingly focused on measuring appropriateness, ensuring quality, and improving value for health spending. This article specifically focuses on four thematic areas: data quality, appropriateness and value, special populations, and policy interventions.
行政数据对于描述急诊护理中影像检查的使用模式、成本及合理性至关重要。这些数据包含一系列主要为非研究用途而收集的源材料:记录临床护理(如病历)、提供护理服务(如图像存档与通信系统)或进行财务交易(如保险理赔)。这些数据已成为大型描述性研究的基础,这些研究记录了诊断性影像检查在急诊科(ED)的兴起及作用的扩大。本文总结了在2015年5月学术急诊医学共识会议“急诊科的诊断性影像检查:优化利用的研究议程”上关于将行政数据用于急诊影像研究的分组讨论情况。作者描述了行政数据已应用于评估急诊科诊断性影像检查使用情况研究的领域、这些数据的常见来源以及行政数据的优势和局限性。接下来,探讨了行政数据在不断发展的卫生系统中回答关键研究问题方面的未来作用,该卫生系统日益注重衡量合理性、确保质量以及提高卫生支出的价值。本文特别关注四个主题领域:数据质量、合理性与价值、特殊人群以及政策干预。