Variation in Outcomes of Quality Measurement by Data Source
Variation in Outcomes of Quality Measurement by Data Source
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DOI：
10.1542/peds.2013-4277
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发表时间：
2014-06-01
期刊：
影响因子：
8
通讯作者：
Devoe, Jennifer E.
中科院分区：
文献类型：
--
作者：
Angier, Heather;Gold, Rachel;Devoe, Jennifer E.
目的：为了评估选定的儿童健康保险计划再授权法案索赔为基础的质量措施，仅使用索赔数据，电子健康记录（EHR）数据单独和两个数据源combined.METHODS：我们的人群包括儿科患者从46个诊所在OCHIN网络的社区卫生中心，谁是连续参加俄勒冈州的公共健康保险计划在2010年。在这一人群中，我们根据行政索赔中的儿童健康保险计划再授权法案技术规范计算了选定的儿科护理质量指标。然后，我们通过使用EHR数据，通过使用技术规范加上先前显示的临床数据来计算同一队列中的这些指标，以增强对给定指标的捕获。当使用索赔与EHR数据时，我们使用k统计量来确定测量的一致性。最后，我们测量了提供给研究人群的护理质量，当使用关联的患者级行政索赔和EHR数据的组合数据集时。结果：当使用行政索赔数据时，1.0%的儿童（3-17岁）记录了BMI百分位数，而基于EHR数据的BMI百分位数为71.9%（k一致性[k]）。
OBJECTIVE: To evaluate selected Children's Health Insurance Program Reauthorization Act claims- based quality measures using claims data alone, electronic health record (EHR) data alone, and both data sources combined.METHODS: Our population included pediatric patients from 46 clinics in the OCHIN network of community health centers, who were continuously enrolled in Oregon's public health insurance program during 2010. Within this population, we calculated selected pediatric care quality measures according to the Children's Health Insurance Program Reauthorization Act technical specifications within administrative claims. We then calculated these measures in the same cohort, by using EHR data, by using the technical specifications plus clinical data previously shown to enhance capture of a given measure. We used the k statistic to determine agreement in measurement when using claims versus EHR data. Finally, we measured quality of care delivered to the study population, when using a combined dataset of linked, patient-level administrative claims and EHR data.RESULTS: When using administrative claims data, 1.0% of children (aged 3-17) had a BMI percentile recorded, compared with 71.9% based on the EHR data (k agreement [k]