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利用常规收集的住院患者数据监测质量并为决策提供依据的可行性:一项使用英国炎症性肠病审计的案例研究

Feasibility of using routinely collected inpatient data to monitor quality and inform choice: a case study using the UK inflammatory bowel disease audit.

作者信息

Roberts Stephen E, Williams John G, Cohen David R, Akbari Ashley, Groves Sam, Button Lori A

机构信息

Centre for Health Information Research and Evaluation, College of Medicine, Swansea University, Swansea, UK.

Health Economics and Policy Research Unit, University of Glamorgan, Pontypridd, UK.

出版信息

Frontline Gastroenterol. 2011 Jul;2(3):153-159. doi: 10.1136/fg.2009.000208. Epub 2011 Apr 5.

Abstract

OBJECTIVE

To assess the utility and cost of using routinely collected inpatient data for large-scale audit.

DESIGN

Comparison of audit data items collected nationally in a designed audit of inflammatory bowel disease (UK IBD audit) with routinely collected inpatient data; surveys of audit sites to compare costs.

SETTING

National Health Service hospitals across England, Wales and Northern Ireland that participated in the UK IBD audit.

PATIENTS

Patients in the UK IBD audit.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Percentage agreement between designed audit data items collected for the UK IBD audit and routine inpatient data items; costs of conducting the designed UK IBD audit and the routine data audit.

RESULTS

There were very high matching rates between the designed audit data and routine data for a small subset of basic important information collected in the UK IBD audit, including mortality; major surgery; dates of admission, surgery, discharge and death; principal diagnoses; and sociodemographic patient characteristics. There were lower matching rates for other items, including source of admission, primary reason for admission, most comorbidities, colonoscopy and sigmoidoscopy. Routine data did not cover most detailed information collected in the UK IBD audit. Using routine data was much less costly than collecting designed audit data.

CONCLUSION

Although valuable for large population-based studies, and less costly than designed data, routine inpatient data are not suitable for the evaluation of individual patient care within a designed audit.

摘要

目的

评估使用常规收集的住院患者数据进行大规模审计的效用和成本。

设计

在一项针对炎症性肠病的设计审计(英国炎症性肠病审计)中全国收集的审计数据项与常规收集的住院患者数据的比较;对审计地点进行调查以比较成本。

设置

参与英国炎症性肠病审计的英格兰、威尔士和北爱尔兰的国民健康服务医院。

患者

英国炎症性肠病审计中的患者。

干预措施

无。

主要观察指标

为英国炎症性肠病审计收集的设计审计数据项与常规住院患者数据项之间的一致性百分比;进行设计的英国炎症性肠病审计和常规数据审计的成本。

结果

在英国炎症性肠病审计中收集的一小部分基本重要信息(包括死亡率、大手术、入院、手术、出院和死亡日期、主要诊断以及患者社会人口学特征)的设计审计数据与常规数据之间存在非常高的匹配率。其他项目的匹配率较低,包括入院来源、入院主要原因、大多数合并症、结肠镜检查和乙状结肠镜检查。常规数据未涵盖英国炎症性肠病审计中收集的大多数详细信息。使用常规数据的成本远低于收集设计审计数据的成本。

结论

尽管常规住院患者数据对基于人群的大型研究有价值且成本低于设计数据,但在设计审计中不适合用于评估个体患者护理。

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