Department of Public Health, Faculty of Medicine, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland.
Department of Information Service and Management, Aalto University School of Business, Espoo, Finland.
BMC Health Serv Res. 2022 Jun 21;22(1):806. doi: 10.1186/s12913-022-08132-w.
The choice of what patient outcomes are included in clinical quality registries is crucial for comparable and relevant data collection. Ideally, a uniform outcome framework could be used to classify the outcomes included in registries, steer the development of outcome measurement, and ultimately enable better patient care through benchmarking and registry research. The aim of this study was to compare clinical quality registry outcomes against the COMET taxonomy to assess its suitability in the registry context.
We conducted an organizational case study that included outcomes from 63 somatic clinical quality registries in use at HUS Helsinki University Hospital, Finland. Outcomes were extracted and classified according to the COMET taxonomy and the suitability of the taxonomy was assessed.
HUS clinical quality registries showed great variation in outcome domains and in number of measures. Physiological outcomes were present in 98%, resource use in all, and functioning domains in 62% of the registries. Patient-reported outcome measures were found in 48% of the registries.
The COMET taxonomy was found to be mostly suitable for classifying the choice of outcomes in clinical quality registries, but improvements are suggested. HUS Helsinki University Hospital clinical quality registries exist at different maturity levels, showing room for improvement in life impact outcomes and in outcome prioritization. This article offers an example of classifying the choice of outcomes included in clinical quality registries and a comparison point for other registry evaluators.
临床质量登记处纳入哪些患者结局至关重要，这对于可比和相关的数据收集至关重要。理想情况下，可以使用统一的结果框架对登记处纳入的结果进行分类，指导结果测量的发展，并最终通过基准测试和登记处研究实现更好的患者护理。本研究的目的是将临床质量登记处的结果与 COMET 分类法进行比较，以评估其在登记处背景下的适用性。
我们进行了一项组织案例研究，其中包括芬兰 HUS 赫尔辛基大学医院使用的 63 个躯体临床质量登记处的结果。根据 COMET 分类法提取和分类结果，并评估分类法的适用性。
HUS 临床质量登记处的结果领域和测量数量存在很大差异。生理结果在所有 98%的登记处中存在，所有资源利用情况都存在，62%的登记处存在功能领域。在 48%的登记处中发现了患者报告的结果测量。
发现 COMET 分类法大多适合对临床质量登记处的结果选择进行分类，但需要改进。HUS 赫尔辛基大学医院临床质量登记处处于不同的成熟水平，在生活影响结果和结果优先级方面有改进的空间。本文提供了一种对临床质量登记处纳入的结果选择进行分类的示例，并为其他登记处评估者提供了一个比较点。
