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国家质量登记处:如何提高数据质量?

National quality registries: how to improve the quality of data?

作者信息

Hoeijmakers Fieke, Beck Naomi, Wouters Michel W J M, Prins Hubert A, Steup Willem H

机构信息

Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.

Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.

出版信息

J Thorac Dis. 2018 Oct;10(Suppl 29):S3490-S3499. doi: 10.21037/jtd.2018.04.146.

Abstract

BACKGROUND

Data of quality registries are increasingly used by healthcare providers, patients, health insurance companies, and governments for monitoring quality of care, hospital benchmarking and outcome research. To provide all stakeholders with reliable information and outcomes, reliable data are of the utmost importance.

METHODS

This article describes methods for quality assurance of data-used by the Dutch Institute for Clinical Auditing (DICA)-regarding: the design of a registry, data collection, data analysis, and external data verification. For the Dutch Lung Cancer Audit for Surgery (DLCA-S) results of data analysis and data verification were assessed with descriptive statistics.

RESULTS

Of all registered patients in the DLCA-S in 2016 (n=2,391), 98.2% was analysable and completeness of data for calculations of transparent outcomes was 90.7%. Data verification for the year 2014 showed a case ascertainment of 99.4%. Of 15 selected hospitals, 14 were verified. All these hospitals received the conclusion 'sufficient quality' on case ascertainment, mortality (0% under-registration) and complicated course (3.3% wrongly registered complications). One hospital was not able to deliver patients lists, and therefore not verified.

CONCLUSIONS

Quality of data can be promoted in many different ways. A completeness indicator and data verification are useful tools to improve data quality. Both methods were used to demonstrate the reliability of registered data in the DLCA-S. Opportunities for further improvement are standardised reporting and adequate data extraction.

摘要

背景

医疗保健提供者、患者、健康保险公司和政府越来越多地使用质量登记处的数据来监测医疗质量、医院基准评估和结果研究。为了向所有利益相关者提供可靠的信息和结果,可靠的数据至关重要。

方法

本文描述了荷兰临床审计研究所(DICA)使用的数据质量保证方法,涉及:登记处的设计、数据收集、数据分析和外部数据验证。对于荷兰肺癌手术审计(DLCA-S),使用描述性统计评估数据分析和数据验证的结果。

结果

在2016年DLCA-S登记的所有患者中(n = 2391),98.2% 可进行分析,用于计算透明结果的数据完整性为90.7%。2014年的数据验证显示病例确诊率为99.4%。在选定的15家医院中,14家经过了验证。所有这些医院在病例确诊、死亡率(登记不足率为0%)和复杂病程(并发症登记错误率为3.3%)方面均得到 “质量足够” 的结论。一家医院无法提供患者名单,因此未经过验证。

结论

可以通过多种不同方式提高数据质量。完整性指标和数据验证是提高数据质量的有用工具。这两种方法都用于证明DLCA-S中登记数据的可靠性。进一步改进的机会在于标准化报告和充分的数据提取。

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