Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults
Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults
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DOI：
10.1136/amiajnl-2013-002333
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发表时间：
2014-07-01
影响因子：
6.4
通讯作者：
DeVoe, Jennifer E.
中科院分区：
文献类型：
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作者：
Heintzman, John;Bailey, Steffani R.;DeVoe, Jennifer E.
比较电子健康记录（EHR）数据与医疗补助索赔数据在记录成人预防保健方面的一致性。保险索赔通常用于衡量护理质量。EHR数据可以用于此目的，但在服务文档中关于如何比较此源的信息很少。对于13101名参加43个俄勒冈州社区卫生中心的医疗补助保险的成年患者，我们比较了11项预防服务的文件，根据EHR与医疗补助索赔数据。大多数服务的文件都是可比的。流感疫苗接种的一致性最高（kappa = 0.77; 95% CI 0.75 - 0.79），胆固醇筛查（kappa = 0.80; 95% CI 0.79 - 0.81），以及宫颈癌筛查（kappa = 0.71; 95%CI 0.70 - 0.73），最低的是通常从初级保健诊所转诊的服务和通常不产生索赔的服务。EHR显示出用于质量报告的希望。需要最大化EHR中数据捕获的策略来优化EHR数据用于服务文档的使用。
To compare the agreement of electronic health record (EHR) data versus Medicaid claims data in documenting adult preventive care. Insurance claims are commonly used to measure care quality. EHR data could serve this purpose, but little information exists about how this source compares in service documentation. For 13 101 Medicaid-insured adult patients attending 43 Oregon community health centers, we compared documentation of 11 preventive services, based on EHR versus Medicaid claims data. Documentation was comparable for most services. Agreement was highest for influenza vaccination (kappa = 0.77; 95% CI 0.75 to 0.79), cholesterol screening (kappa = 0.80; 95% CI 0.79 to 0.81), and cervical cancer screening (kappa = 0.71; 95% CI 0.70 to 0.73), and lowest on services commonly referred out of primary care clinics and those that usually do not generate claims. EHRs show promise for use in quality reporting. Strategies to maximize data capture in EHRs are needed to optimize the use of EHR data for service documentation.