TY - JOUR
T1 - Assessing surgical quality using administrative and clinical data sets
T2 - A direct comparison of the university healthsystem consortium clinical database and the national surgical quality improvement program data set
AU - Davenport, Daniel L.
AU - Holsapple, Clyde W.
AU - Conigliaro, Joseph
PY - 2009/9/10
Y1 - 2009/9/10
N2 - The use of "clinical" versus "administrative" data sets for health care quality assessment continues to be debated. This study directly compares the University HealthSystem Consortium Clinical Database (UHC CDB) and the National Surgical Quality Improvement Program (NSQIP) in terms of their assessment of complications and death for 26 322 surgery patients using analyses of variance, correlation, and multivariable logistic regression. The NSQIP had more variables with significant correlation with outcomes. The NSQIP was better at predicting death (c-index 0.94 vs 0.90, <.05) and complications (c-index 0.78 vs 0.76, P<=.07), especially for higher risk patients. The UHC CDB missed and misclassified several major complications. The data sets are similar in their explanatory power relative to outcomes, but the clinical data set is better, particularly at identifying higher risk patients and specific complications. It should prove more useful for initiating and monitoring clinical process improvements because of more clinically relevant variables.
AB - The use of "clinical" versus "administrative" data sets for health care quality assessment continues to be debated. This study directly compares the University HealthSystem Consortium Clinical Database (UHC CDB) and the National Surgical Quality Improvement Program (NSQIP) in terms of their assessment of complications and death for 26 322 surgery patients using analyses of variance, correlation, and multivariable logistic regression. The NSQIP had more variables with significant correlation with outcomes. The NSQIP was better at predicting death (c-index 0.94 vs 0.90, <.05) and complications (c-index 0.78 vs 0.76, P<=.07), especially for higher risk patients. The UHC CDB missed and misclassified several major complications. The data sets are similar in their explanatory power relative to outcomes, but the clinical data set is better, particularly at identifying higher risk patients and specific complications. It should prove more useful for initiating and monitoring clinical process improvements because of more clinically relevant variables.
KW - Contextual data quality
KW - National Surgical Quality Improvement Program
KW - Surgical morbidity and mortality
KW - Surgical quality assessment
KW - University HealthSystem Consortium
UR - http://www.scopus.com/inward/record.url?scp=70349451585&partnerID=8YFLogxK
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U2 - 10.1177/1062860609339936
DO - 10.1177/1062860609339936
M3 - Article
C2 - 19584374
AN - SCOPUS:70349451585
SN - 1062-8606
VL - 24
SP - 395
EP - 402
JO - American Journal of Medical Quality
JF - American Journal of Medical Quality
IS - 5
ER -