title: [Quality assurance with administrative data (QSR): follow-up in quality measurement - an analysis of patient records].
abstract: The present study analyses the information gain obtained by evaluating adverse events during follow-up compared to the sole analysis of events during the initial hospital stay for quality measurement purposes. The analysis is based on AOK administrative data from the years 2010 to 2012. The analyses were carried out for 10 quality indicators from the 4 QSR sectors knee replacement for osteoarthritis, appendectomy, prostate surgery for benign prostatic syndrome (BPS) and therapeutic cardiac catheterization (PCI) in patients with myocardial infarction. A total of 409,774 AOK cases were included. For almost all indicators considered, a relevant share of complications can be found to have occurred only after discharge from the initial hospitalization (7.7 %-92.6 %). Furthermore, there is only a weak connection between the findings from the first hospitalization and those from the follow-up period (0.0449 < r < 0.1935). 26-66 % of the hospitals will be classified differently based on Standardized Mortality/Morbidity Ratio (SMR) quartiles if follow-up events are included in the quality assessment (with the exception of "Other Complications after PCI" of 14 %). In summary, quality assessment is improved considerably by evaluating the follow-up period for almost all indicators considered. A quality measurement based solely on events in the initial hospital stay obscures relevant adverse events that have an impact on a comparative hospital quality assessment for these indicators.
authors.affiliation: Wissenschaftliches Institut der AOK (WIdO), Berlin, Deutschland. Electronic address: elke.jeschke@wido.bv.aok.de.
authors.forename: Elke
authors.initials: E
authors.lastname: Jeschke
authors.affiliation: Wissenschaftliches Institut der AOK (WIdO), Berlin, Deutschland.
authors.forename: Christian
authors.initials: C
authors.lastname: Günster
authors.affiliation: Wissenschaftliches Institut der AOK (WIdO), Berlin, Deutschland.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Klauber
mesh_terms: D001062:Appendectomy / Q000401:mortality / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000401:mortality / Q000706:statistics & numerical data; D006328:Cardiac Catheterization / Q000401:mortality / Q000706:statistics & numerical data; D003625:Data Collection / Q000379:methods* / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D005858:Germany; D017052:Hospital Mortality; D006753:Hospital Records / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008501:Medical Records, Problem-Oriented / Q000706:statistics & numerical data*; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy; D020370:Osteoarthritis, Knee / Q000401:mortality / Q000601:surgery; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D011468:Prostatectomy / Q000401:mortality / Q000706:statistics & numerical data; D011470:Prostatic Hyperplasia / Q000401:mortality / Q000601:surgery; D011785:Quality Assurance, Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D012086:Reoperation / Q000401:mortality / Q000706:statistics & numerical data
keywords: Appendektomie; Herzkatheter; Kniegelenkersatz; Prostataoperation; Qualitätsindikatoren; Routine data; Routinedaten; appendectomy; cardiac catheter; knee replacement; prostate surgery; quality indicators