Statewide Hospital Discharge Data: Collection, Use, Limitations, and Improvements
Statewide Hospital Discharge Data: Collection, Use, Limitations, and Improvements
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DOI：
10.1111/1475-6773.12343
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发表时间：
2015-08-01
影响因子：
3.4
通讯作者：
Andrews, Roxanne M.
中科院分区：
文献类型：
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作者：
Andrews, Roxanne M.
ObjectivesTo提供一个概述全州医院出院数据库（HDD），包括其在卫生服务的研究和局限性的使用，并描述机构的医疗保健研究和质量（AHRQ）增强状态数据赠款，以解决临床和种族-种族数据limitations.Principal FindingsAlmost所有国家全州HDD收集的公共或私人数据组织。全州HDD，基于医院索赔与国家的变化，包含有用的核心变量，并要求最小的收集负担。AHRQ的医疗保健成本和利用项目使用全州HDD建立统一的州和国家研究文件。州、医院和研究人员将全州范围的HDD用于许多目的。说明研究人员的使用，在2012年至2014年期间，HSR发表了26篇基于HDD的文章，涉及卫生政策、获取、质量、护理的临床方面、种族-民族和保险影响、经济学、融资和研究方法。HDD有影响其使用的限制。五个AHRQ赠款集中在提高临床数据和三个赠款，旨在改善种族，民族data.ConclusionICD-10的实施将显着影响HDD。AHRQ赠款，信息技术的进步，支付政策的变化，以及对门诊信息的需求可能会刺激其他全州HDD的变化。为了保持健康服务研究的支柱，全州范围内的HDD需要跟上不断变化的用户需求，同时尽量减少收集负担。
ObjectivesTo provide an overview of statewide hospital discharge databases (HDD), including their uses in health services research and limitations, and to describe Agency for Healthcare Research and Quality (AHRQ) Enhanced State Data grants to address clinical and race-ethnicity data limitations.Principal FindingsAlmost all states have statewide HDD collected by public or private data organizations. Statewide HDD, based on the hospital claim with state variations, contain useful core variables and require minimal collection burden. AHRQ's Healthcare Cost and Utilization Project builds uniform state and national research files using statewide HDD. States, hospitals, and researchers use statewide HDD for many purposes. Illustrating researchers' use, during 2012-2014, HSR published 26 HDD-based articles on health policy, access, quality, clinical aspects of care, race-ethnicity and insurance impacts, economics, financing, and research methods. HDD have limitations affecting their use. Five AHRQ grants focused on enhancing clinical data and three grants aimed at improving race-ethnicity data.ConclusionICD-10 implementation will significantly affect the HDD. The AHRQ grants, information technology advances, payment policy changes, and the need for outpatient information may stimulate other statewide HDD changes. To remain a mainstay of health services research, statewide HDD need to keep pace with changing user needs while minimizing collection burdens.