Roos L L, Sharp S M, Wajda A
Faculty of Management, University of Manitoba, Winnipeg, Canada.
Soc Sci Med. 1989;28(2):175-82. doi: 10.1016/0277-9536(89)90145-7.
With the growing reliance on large health care data bases, the need to verify data quality increases as well. Because of the considerable costs involved in checks using primary data collection, a computerized methodology for performing such checks is suggested. The technique seems appropriate for any situation where two data collection systems (i.e. hospital discharge abstracts and physician claims for payment) relate to the same event, such as a patient's hospitalization. After reviewing other approaches, this paper suggests linking physician claims for performing particular surgical procedures with hospital discharge abstracts for the stay in which the surgery took place. Physician and hospital data for adults age 25 and over in Manitoba from 1 April, 1979 to 31 March, 1984 were used to address the questions: 1. How well can the two data sets be linked? 2. Given linkage of the two data sets, how much agreement is there as to procedure and diagnosis? Linkage between hospital and physician data was excellent (over 95%) for 5 out of 11 surgical procedures (hysterectomy, prostatectomy, total hip replacement, coronary artery bypass surgery, and heart valve replacement); there was over 90% perfect agreement for three other procedures (cholecystectomy, cataract surgery and total knee replacement). Problems with matching the Manitoba Health Services Commission tariffs (on physician claims) with ICD-9-CM operation codes (on hospital data) led to only 77% perfect agreement for vascular surgery and 84% for gallbladder and biliary tract operations other than cholecystectomy; over 10% of the cases linked on surgeon and date but not on the designated procedures.(ABSTRACT TRUNCATED AT 250 WORDS)
随着对大型医疗数据库的依赖日益增加，核实数据质量的需求也随之上升。由于使用原始数据收集进行检查的成本相当高，因此建议采用一种计算机化方法来进行此类检查。该技术似乎适用于任何两种数据收集系统（即医院出院摘要和医生付款申请）与同一事件相关的情况，例如患者住院。在回顾了其他方法后，本文建议将医生进行特定外科手术的申请与手术发生期间的医院出院摘要相联系。使用了1979年4月1日至1984年3月31日期间曼尼托巴省25岁及以上成年人的医生和医院数据来解决以下问题：1. 这两个数据集的关联程度如何？2. 给定两个数据集的关联，在手术程序和诊断方面有多少一致性？对于11种外科手术中的5种（子宫切除术、前列腺切除术、全髋关节置换术、冠状动脉搭桥手术和心脏瓣膜置换术），医院和医生数据之间的关联非常好（超过95%）；另外三种手术（胆囊切除术、白内障手术和全膝关节置换术）的完全一致性超过90%。将曼尼托巴省卫生服务委员会的收费标准（医生申请）与ICD - 9 - CM手术代码（医院数据）进行匹配时出现的问题，导致血管手术的完全一致性仅为77%，胆囊切除术以外的胆囊和胆道手术为84%；超过10%的病例按外科医生和日期关联，但未按指定程序关联。（摘要截短至250字）
