title: Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage.
abstract: Assessment of quality of care in patients with myocardial infarction (MI) should be based on data that effectively enable determination of quality. With the need to simplify measurement techniques, the question arises whether routine data can be used for this purpose. We therefore compared data from a German sickness fund (AOK) with data from the Berlin Myocardial Infarction Registry (BMIR).
  
  
  
  We included patients hospitalised for treatment of MI in Berlin from 2009-2011. We matched 2305 patients from AOK and BMIR by using deterministic record linkage with indirect identifiers. For matched patients we compared the frequency in documentation between AOK and BMIR for quality assurance variables and calculated the kappa coefficient (KC) as a measure of agreement.
  
  
  
  There was almost perfect agreement in documentation between AOK and BMIR data for matched patients for: catheter laboratory (KC: 0.874), ST elevation MI (KC: 0.826), diabetes (KC: 0.818), percutaneous coronary intervention (KC: 0.860) and hospital mortality (KC: 0.952). The remaining variables compared showed moderate or less than moderate agreement (KC < 0.6), and were grouped in Category II with less frequent documentation in AOK for risk factors and aspects of patients' history; in Category III with more frequent documentation in AOK for comorbidities; and in Category IV for medication at and after hospital discharge.
  
  
  
  Routine data are primarily collected and defined for reimbursement purposes. Quality assurance represents merely a secondary use. This explains why only a limited number of variables showed almost perfect agreement in documentation between AOK and BMIR. If routine data are to be used for quality assessment, they must be constantly monitored and further developed for this new application. Furthermore, routine data should be complemented with registry data by well-established methods of record linkage to realistically reflect the situation - also for those quality-associated variables not collected in routine data.
authors: Berlin Myocardial Infarction Registry, Technische Universität, Berlin, Germany. birga.maier@tu-berlin.de.
authors: Birga
authors: B
authors: Maier
authors: Berlin Myocardial Infarction Registry, Technische Universität, Berlin, Germany.
authors: Katrin
authors: K
authors: Wagner
authors: Department of Cardiology, Vivantes Humboldt Klinikum, Berlin, Germany.
authors: Steffen
authors: S
authors: Behrens
authors: Department of Cardiology, Unfallkrankenhaus Berlin, Berlin, Germany.
authors: Leonhard
authors: L
authors: Bruch
authors: Department of Health Care Management, Technische Universitaet, Berlin, Germany.
authors: Reinhard
authors: R
authors: Busse
authors: Department Hospital Affairs, AOK Nordost, Berlin, Germany.
authors: Dagmar
authors: D
authors: Schmidt
authors: Department of Cardiology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany.
authors: Helmut
authors: H
authors: Schühlen
authors: Department of Cardiology, Jüdisches Krankenhaus, Berlin, Germany.
authors: Roland
authors: R
authors: Thieme
authors: Department of Cardiology, Medical Park Humboldt Muehle, Berlin, Germany.
authors: Heinz
authors: H
authors: Theres
mesh_terms: D000368:Aged; D015897:Comorbidity; D004282:Documentation; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D010351:Patient Discharge / Q000706:statistics & numerical data; D062645:Percutaneous Coronary Intervention; D011787:Quality of Health Care; D012042:Registries; D012307:Risk Factors
keywords: Health services research; Hospital performance; Myocardial infarction; Quality of care; Routine administrative data