Using Routine Data to Evaluate Quality of Care in British Hospitals
Medical CarePublished 1 October 1997
Martin McKee, Philip James
Citations22
SJR quartileQ1
SJR score1.57
SNIP1.38
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
British administrative data can be used to describe patterns of care and have the potential to identify possible differences in outcome that can then be subjected to more detailed scrutiny.
Abstract
British administrative data can be used to describe patterns of care and have the potential to identify possible differences in outcome that can then be subjected to more detailed scrutiny. They are substantially less detailed than US data but are also somewhat less costly to collect.
Keywords
Health ProfessionsEconomics, Econometrics and Finance
Journal of Clinical EpidemiologyAdapting a clinical comorbidity index for use with ICD-9-CM administrative databases
10,426 Citations1992Richard A. Deyo
It is concluded that the adapted comorbidity index will be useful in studies of disease outcome and resource use employing administrative databases.
New England Journal of MedicineAccuracy of Diagnostic Coding for Medicare Patients under the Prospective-Payment System
494 Citations1988David C. Hsia, W. Mark Krushat +3 more
It is concluded that "creep" does occur in the coding of DRGs, resulting in overpayment to hospitals for patients covered by Medicare, and a statistically significant 61.7 percent of coding errors favored the hospital.
JAMAComorbidities, complications, and coding bias. Does the number of diagnosis codes matter in predicting in-hospital mortality?
451 Citations1992Lisa I. Iezzoni
New England Journal of MedicineReport Cards on Cardiac Surgeons — Assessing New York State's Approach
389 Citations1995J Green, Neil Wintfeld
Publication of “report cards” on hospitals and surgeons is an important new trend and the New York State Department of Health pioneered this practice by developing the Cardiac Surgery Reporting System (CSRS), which generated the first physician-specific mortality report ever published.
New England Journal of MedicineHospital Inpatient Mortality
311 Citations1987Robert W. Dubois, William H. Rogers +3 more
The findings indicate that high-outlier hospitals care for sicker patients, however, these same hospitals or their medical staffs may also provide poorer care.
JAMAExplaining variations in hospital death rates. Randomness, severity of illness, quality of care
222 Citations1990R E Park
International Journal of Technology Assessment in Health CareUsing Administrative Diagnostic Data to Assess the Quality of Hospital Care: Pitfalls and Potential of ICD-9-CM
168 Citations1990Lisa I. Iezzoni
The purpose of this article is to introduce ICD-9-CM, to review its strengths and limitations, and to suggest ways that it can be used through administrative files for assessing the quality of hospital care.
The LancetVariation in outcome after acute upper gastrointestinal haemorrhage
164 Citations1995Tim Rockall, Hugh Devlin +2 more
The effect of risk standardisation on hospital mortality after acute upper gastrointestinal haemorrhage varies widely and simple league tables of crude mortality are misleading and cannot be regarded as a reflection of the quality of health care.
BMJIntensive Care Society's APACHE II study in Britain and Ireland--I: Variations in case mix of adult admissions to general intensive care units and impact on outcome.
160 Citations1993Kathy Rowan, John Kerr +4 more
Comparing crude death rates in hospital between intensive care units may be misleading indicators of performance and the collection of data on case mix needs to be standardised and differences in case mix adjusted for when comparing outcome between differentintensive care units.
BMJEffect of correcting outcome data for case mix: an example from stroke medicine
94 Citations1996R. J Davenport, Martin Dennis +1 more
Variations in case mix have a crucial influence on the interpretation of outcome data, and this is particularly important in non-randomised comparative studies, which are likely to become increasingly common in the new reformed NHS.
American Journal of Public HealthUsing computers to identify complications after surgery.
93 Citations1985Leslíe L. Roos, Sandra M. Cageorge +2 more
Journal of Clinical EpidemiologyRisk adjustment in claims-based research: The search for efficient approaches
89 Citations1989Leslíe L. Roos, Sandra M. Sharp +2 more
Claims-based indices of comorbidity and severity, as well as other measures derived from routinely collected administrative data, are developed and tested and difficulties in improving risk adjustment by more intensive data collection are discussed.
Journal of Epidemiology & Community HealthReliability of routine hospital data on poisoning as measures of deliberate self poisoning in adolescents.
76 Citations1990C. Sellar, Michael J Goldacre +1 more
Deliberate self poisoning in adolescents can be identified through routinely collected hospital statistics and a very high percentage of the diagnostic information on poisoning in ORLS files is correctly recorded.
BMJ Quality & SafetyRoutine data: a resource for clinical audit?
73 Citations1993Martin McKee
Examination of the appropriateness, quality, and accessibility of routinely collected data for clinical audit finds that routine data are seen as of little use in audit.
PubMedComments on HCFA hospital death rate statistical outliers. Health Care Financing Administration.
71 Citations1987Blumberg Ms
In March 1986, the Health Care Financing Administration released ten lists of death-rate "outlier" hospitals, one for all 1984 Medicare discharges and nine for specific DRGs, where a total of 1,222 hospitals had unfavorable residuals, while only 8 were favorable.
BMJ Quality & SafetyMortality league tables: do they inform or mislead?
66 Citations1995Martin McKee, Duncan Hunter
Examination of methodological issues related to the publication of mortality league tables, with particular reference to severity adjustment and sample size, finds that Rankings of hospitals by death rate are sensitive to adjustment for severity of disease.
BMJThe consultant episode: an unhelpful measure.
58 Citations1992Aileen Clarke, Martin McKee
The role of the matrix metalloproteinase stromelysin in the progression of squamous cell carcinoma and its identity to erythroid-potentiating activity is investigated.
BMJ Quality & SafetyComparative hospital databases: value for management and quality.
49 Citations1994Robert K. Cleary, R.W. Beard +5 more
Current methods of extracting and coding diagnostic and procedural data from case notes in this sample of hospitals is unsatisfactory: notes were difficult to access and recording is unacceptably incomplete.
BMJCaseload or workload? Scoring complexity of operative procedures as a means of analysing workload.
33 Citations1990Stephen M. Jones, Charles Collins
The use of the intermediate equivalent values as an indicator of complexity allows a more realistic assessment of the operative workload than a simple case count of the number of different operations and is recommended for comparing workload in different hospitals and departments.
BMJThe language of health.
30 Citations1993Richard Buckland
Until there is good evidence that attempts to modify the ecology of the gastrointestinal tract are beneficial, attention to accepted standards and the further development of a multidisciplinary approach to infection in intensive care units are likely to reap greater rewards.
Medical CareAdmission and Mid-Stay MedisGroups?? Scores as Predictors of Hospitalization Charges
25 Citations1991Lisa I. Iezzoni, Arlene S. Ash +2 more
This study examines the ability of MedisGroups®, a severity measure based on clinical data abstracted from the medical record, to predict hospitalization charges, and found that higher admission and mid-stay severity scores were generally associated with higher charges.
Public HealthThe completeness and accuracy of health authority and cancer registry records according to a study of ovarian neoplasms
22 Citations1991A.K. Mukherjee, Ian Leck +2 more
The completeness and accuracy of Hospital Activity Analysis (HAA) and Regional Cancer Registry (RCR) records were investigated in a series of 868 histologically reviewed cases in which primary ovarian neoplasms had been diagnosed according to one or more of seven data sources including HAA and RCR.
Journal of Public HealthDisease Staging — a case-mix system for purchasers?
15 Citations1993Martin McKee, Mark Petticrew
Disease Staging can be used with UK data to produce groups that are homogeneous both in terms of length of stay and mortality, and its logic is acceptable to UK clinicians.
Journal of Public HealthPIS and DRGs: coding inaccuracies and their consequences for resource management
15 Citations1991S.H. Smith, Christopher J. Kershaw +2 more
The resource implications of assiduous quality control of recording, coding and computing is pointed out, and it is suggested that improved classification systems should be assessed for use in the NHS.
Journal of Epidemiology & Community HealthChallenges of monitoring use of secondary care at local level: a study based in London, UK.
15 Citations1996Laurent Chenet, Martin McKee
This paper provides a framework for those working at district level to begin to analyse the association between hospitalisation and deprivation locally and identifies some of the issues that must be taken into account when seeking to interpret these data.
Journal of Evaluation in Clinical PracticeMeasuring the effects of casemix on outcomes
11 Citations1996Carol Orchard
Observational data, particularly from routine hospital statistics, are useful complements to experimental data provided that their variable quality is taken into account and adjustments are made to minimize bias and confounding.
PubMedPMCs--an alternative to DRGs for trauma care reimbursement.
8 Citations1991Wendy Young, D Macioce
The Journal of Trauma: Injury, Infection, and Critical CarePMCs—An Alternative to DRGs for Trauma Care Reimbursement
7 Citations1991WANDA W. YOUNG, DARREN P. MACIOCE
