title: Towards using administrative databases to measure population-based indicators of quality of end-of-life care: testing the methodology.
abstract: This study is concerned with methods to measure population-based indicators of quality end-of-life care. Using a retrospective cohort approach, we assessed the feasibility, validity and reliability of using administrative databases to measure quality indicators of end-of-life care in two Canadian provinces. The study sample consisted of all females who died of breast cancer between 1 January 1998 and 31 December 2002, in Nova Scotia or Ontario, Canada. From an initial list of 19 quality indicators selected from the literature, seven were determined to be fully measurable in both provinces. An additional seven indicators in one province and three in the other province were partially measurable. Tests comparing administrative and chart data show a high level of agreement with inter-rater reliability, confirming consistency in the chart abstraction process. Using administrative data is an efficient, population-based method to monitor quality of care which can compliment other methods, such as qualitative and purposefully collected clinical data.
authors.affiliation: Cancer Outcomes Research Program, Cancer Care Nova Scotia, Dalhousie University, Halifax, Canada. eva.grunfeld@ccns.nshealth.ca
authors.forename: Eva
authors.initials: E
authors.lastname: Grunfeld
authors.forename: Lynn
authors.initials: L
authors.lastname: Lethbridge
authors.forename: Ron
authors.initials: R
authors.lastname: Dewar
authors.forename: Beverley
authors.initials: B
authors.lastname: Lawson
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Paszat
authors.forename: Grace
authors.initials: G
authors.lastname: Johnston
authors.forename: Frederick
authors.initials: F
authors.lastname: Burge
authors.forename: Paul
authors.initials: P
authors.lastname: McIntyre
authors.forename: Craig C
authors.initials: CC
authors.lastname: Earle
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy; D002170:Canada; D002173:Cancer Care Facilities / Q000592:standards*; D015331:Cohort Studies; D019992:Databases as Topic; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008499:Medical Records; D017064:Process Assessment, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013727:Terminal Care / Q000592:standards*