title: Data quality issues impede comparability of hospital treatment delay performance indicators.
abstract: OBJECTIVE
  To assess the comparability of five performance indicator scores for treatment delay among patients diagnosed with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention in relation to the quality of the underlying data.
  
  
  METHODS
  Secondary analyses were performed on data from 1017 patients in seven Dutch hospitals. Data were collected using standardised forms for patients discharged in 2012. Comparability was assessed as the number of occasions the indicator threshold was reached for each hospital.
  
  
  RESULTS
  Hospitals recorded different time points based on different interpretations of the definitions. This led to substantial differences in indicator scores, ranging from 57 to 100 % of the indictor threshold being reached. Some hospitals recorded all the required data elements for calculating the performance indicators but none of the data elements could be retrieved in a fully automated way. Moreover, recording accessibility and completeness of time points varied widely within and between hospitals.
  
  
  CONCLUSIONS
  Hospitals use different definitions for treatment delay and vary greatly in the extent to which the necessary data are available, accessible and complete, impeding comparability between hospitals. Indicator developers, users and hospitals providing data should be aware of these issues and aim to improve data quality in order to facilitate comparability of performance indicators.
authors.affiliation: The Netherlands Institute of Health Services Research (NIVEL), Utrecht, The Netherlands, l.verweij@nivel.nl.
authors.forename: L M
authors.initials: LM
authors.lastname: Verweij
authors.forename: J
authors.initials: J
authors.lastname: Tra
authors.forename: J
authors.initials: J
authors.lastname: Engel
authors.forename: R A
authors.initials: RA
authors.lastname: Verheij
authors.forename: M C
authors.initials: MC
authors.lastname: de Bruijne
authors.forename: C
authors.initials: C
authors.lastname: Wagner