Document Detail


Comparing clinical automated, medical record, and hybrid data sources for diabetes quality measures.
MedLine Citation:
PMID:  12369158     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Little is known about the relative reliability of medical record and clinical automated data, sources commonly used to assess diabetes quality of care. The agreement between diabetes quality measures constructed from clinical automated versus medical record data sources was compared, and the performance of hybrid measures derived from a combination of the two data sources was examined. METHODS: Medical records were abstracted for 1,032 patients with diabetes who received care from 21 facilities in 4 Veterans Integrated Service Networks. Automated data were obtained from a central Veterans Health Administration diabetes registry containing information on laboratory tests and medication use. RESULTS: Success rates were higher for process measures derived from medical record data than from automated data, but no substantial differences among data sources were found for the intermediate outcome measures. Agreement for measures derived from the medical record compared with automated data was moderate for process measures but high for intermediate outcome measures. Hybrid measures yielded success rates similar to those of medical record-based measures but would have required about 50% fewer chart reviews. CONCLUSIONS: Agreement between medical record and automated data was generally high. Yet even in an integrated health care system with sophisticated information technology, automated data tended to underestimate the success rate in technical process measures for diabetes care and yielded different quartile performance rankings for facilities. Applying hybrid methodology yielded results consistent with the medical record but required less data to come from medical record reviews.
Authors:
Eve A Kerr; Dylan M Smith; Mary M Hogan; Sarah L Krein; Leonard Pogach; Timothy P Hofer; Rodney A Hayward
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Joint Commission journal on quality improvement     Volume:  28     ISSN:  1070-3241     ISO Abbreviation:  Jt Comm J Qual Improv     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-08     Completed Date:  2002-10-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9315239     Medline TA:  Jt Comm J Qual Improv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  555-65     Citation Subset:  IM    
Affiliation:
VA Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA. ekerr@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure Determination
Cholesterol, LDL / blood
Data Collection / methods*
Delivery of Health Care, Integrated / standards*
Diabetes Mellitus / prevention & control*
Diabetic Foot / diagnosis
Diabetic Nephropathies / diagnosis
Diabetic Retinopathy / diagnosis
Hemoglobin A, Glycosylated / analysis
Humans
Medical Records*
Medical Records Systems, Computerized*
Middle Aged
Outcome and Process Assessment (Health Care) / methods*
Quality Indicators, Health Care*
Registries
Sampling Studies
United States
United States Department of Veterans Affairs
Veterans
Chemical
Reg. No./Substance:
0/Cholesterol, LDL; 0/Hemoglobin A, Glycosylated

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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