Clinically enhanced multi-purpose administrative dataset for comparative effectiv

描述（由申请人提供）：比较有效性研究日益成为医疗保健研究、决策和质量改进过程中的重要工具。新颁布的卫生保健改革确立了卫生保健服务的新观点，强调并鼓励控制成本和有效利用资源。缺乏关键的比较成本效益信息来评估干预方案，使护理提供者、消费者、决策方以及其他利益攸关方能够对现有的替代方案作出知情的决定和选择，这可能妨碍实现新的保健改革可能产生的可累积效益。佛罗里达州的医疗保健系统非常昂贵，全球每年的医疗保健支出都在增长，个人医疗保健和人均医疗保健支出都超过了全国平均水平。全州范围内缺乏可靠且经过严格验证的大型临床增强管理数据库，这阻碍了公共卫生和其他研究人员提供循证数据的能力，这些数据可以为该州的决策提供信息，并提高卫生保健资源的有效利用。正是由于这个原因，这个拨款提案中的项目对该州来说是资本，因为它设想填补这一空白，这是佛罗里达州在新颁布的国家医疗改革下，在未来成功实现具有成本效益和高效的医疗保健提供系统的必要步骤。选择妇幼保健作为重点是及时和明智的，因为尽管花费巨大，佛罗里达州在预防孕产妇死亡和早产方面的表现低于全国其他地区的平均水平。正是由于这些原因，我们提出了这项研究，其具体目标如下：具体目标1：通过与其他数据源的联系，通过增加当前全州住院数据文件，为佛罗里达州创建一个扩大的临床增强母婴数据集；具体目标2：通过严格的流程验证具体目标1中创建的数据集，从而建立公众对数据集使用的信心；具体目标3：以早期选择性分娩为例，展示新创建的丰富数据集在进行比较有效性分析中的效用。该项目的数据集将包括以下数据来源的信息：出生证明、住院出院数据、门诊和急诊科数据、财务数据和佛罗里达州孕产妇死亡率数据。该项目的成功是有保证的，因为该项目是基于现有的公司全州合作伙伴关系，该合作伙伴关系已经完成了早期的数据链接活动，从而产生了一个精炼的数据集，该数据集将作为本赠款提议活动的主要模板。该项目对佛罗里达州很重要，因为它可能导致开展研究，提供所需的关键信息，使保健利益攸关方能够有效地促进最佳临床做法，并监测质量改进，以实现提高该州母婴健康的总体目标。

DESCRIPTION (provided by applicant): Comparative effectiveness research is increasingly becoming an essential tool in health care research, and decision-making, and quality improvement process. The newly enacted health care reform establishes a new perspective of health care services with emphasis and incentives for cost-containment and efficient utilization of resources. The paucity of critical comparative cost-effectiveness information to assess intervention options that will enable care providers, consumers, decision-making parties as well as other stakeholders to make informed decisions and choices on available alternatives could hamper the realization of the potentially accruable benefits of the new health care reform. The state of Florida suffers from a very costly health care system with global annual health care expenditure growth, personal health care and per capita health care expenditures that exceed the national average. The virtual absence of reliable and rigorously validated large, clinically enhanced administrative databases statewide hinders the ability of public health and other researchers to offer evidence-based data that could inform decision-making and improve efficient utilization of health care resources in the state. It is for this reason that the project in this grant proposal is capital for the state because it envisages filling this gap, which is a necessary step if Florida is to succeed in achieving a cost-effective and efficient health care delivery system in the future under the newly enacted national health care reform. The choice of maternal and child health as a focus is timely and well-informed because despite huge spending, Florida is performing below average compared to the rest of the nation in preventing maternal deaths and preterm births. It is for these reasons that we propose this study with the following specific aims: Specific Aim 1: To create an expanded clinically enhanced maternal-infant dataset for the State of Florida by augmenting the current statewide hospitalization data files through linkages to other data sources; Specific Aim 2: To validate the created dataset in Specific Aim 1 through a rigorous process that will establish confidence in the use of the dataset by the public; Specific Aim 3: To demonstrate the utility of the newly created enriched dataset in conducting comparative effectiveness analysis using early term elective delivery as a case study. The dataset from the project will encompass information from the following data sources: the birth certificate, in-patient hospital discharge data, ambulatory and emergency department data, financial data and Florida maternal mortality data. The success of the project is assured because the undertaking is based on an existing firm statewide partnership that has already completed an earlier data linkage activity that resulted in a refined dataset which will serve as the main template for the activities proposed for this grant. The project is important for Florida because it could lead to research that will provide critical information required to enable health care stakeholders effectively promote best clinical practices and to monitor quality improvement with the overall objective of enhancing maternal-infant health in the state. PUBLIC HEALTH RELEVANCE: The aim of this study is to create a reliable large statewide database that contains clinical and non-clinical information which will be useful for comparative effectiveness research and will serve as a tool for quality improvement with the overall objective of enhancing overall population health. The newly created dataset from the project will encompass information from the following data sources: the birth certificate, in-patient hospital discharge data, ambulatory and emergency department data, financial data and Florida maternal mortality data. The proposed project enjoys a strong statewide collaborative partnership that has been working together for sometime now to attain some of the objectives spelled out for this grant, and hence, the proposal has a very high probability of success.