The utility of administrative data for measuring adherence to cancer surveillance care guidelines
The utility of administrative data for measuring adherence to cancer surveillance care guidelines
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DOI：
10.1097/01.mlr.0000241107.15133.54
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发表时间：
2007-01-01
期刊：
影响因子：
3
通讯作者：
Lafata, Jennifer Elston
中科院分区：
文献类型：
--
作者：
Cooper, Gregory S.;Schultz, Lonni;Lafata, Jennifer Elston
背景资料：癌症幸存者对专业社会指南的随访或监测护理的依从性通常通过病历审查来衡量。管理数据代表了一种替代方法，它可能包含大量患者，且增量成本相对较低。目的：我们试图确定使用索赔数据来衡量指南依从性的可行性。方法：通过回顾429例接受治疗性治疗的5种常见癌症中的1种患者的纸质和电子病历和索赔数据，我们比较了具体的程序收据以及从索赔和医疗记录数据中得出的指南依从性分类。通过Kappa statistics.Measures测量一致性：在最初的18个月的随访期间的护理特点是低于推荐，推荐，或大于推荐的每一个实践指南在医疗记录和行政data.Results：匹配率为个别程序各不相同，一般最高的某些实验室检查和最低的体检。在索赔数据和医疗记录数据中，患者分类之间的一致性通常为良好至优秀水平（kappa = 0.34-0.96）。没有一致的差异，观察到根据保险type.Conclusions协议：在一般情况下，索赔数据采集程序和访问使用的特征准则的遵守是可比的，记录在医疗记录，并表明，如果在其他环境中验证，行政数据可以用来描述模式的后续护理。
Background: Adherence to professional society guidelines for follow-up or surveillance care in cancer survivors usually is measured with medical record review. Administrative data represent an alternative approach that may encompass larger numbers of patients with relatively low incremental costs.Objectives: We sought to determine the feasibility of using claims data to measure guideline adherence.Methods: By reviewing paper and electronic medical records and claims data of 429 patients with I of 5 common cancers who received treatment with curative intent, we compared specific procedure receipt as well as guideline adherence classification as derived from claims and medical record data. Concordance was measured via kappa statistics.Measures: Care in the initial 18-month follow-up period was characterized as less than recommended, recommended, or greater than recommended per practice guidelines in both medical record and administrative data.Results: Matching rates for individual procedures varied and were generally highest for certain laboratory tests and lowest for physical examinations. There were generally good-to-excel lent levels of agreement (kappa = 0.34-0.96) between a patient's classification in claims data and medical record data. No consistent differences in agreement were observed according to insurance type.Conclusions: In general, claims data capturing procedures and visit use for characterizing guideline adherence was comparable with what was documented in the medical record and suggests that if validated in other settings, administrative data could be used to describe patterns of follow up care.