Registries for Evaluating Patient Outcomes


Book Description

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.




Linking Data for Health Services Research


Book Description

Health registries greatly enhance health services research, especially when linked with other data sources such as administrative claims. Recently, concerns about patient privacy and data security have produced policies such as the Health Insurance Portability and Accountability Act (HIPAA) that reduce the availability of sensitive identifying information. In this context, the development of effective record linkage approaches for varying scenarios of data availability is critical. This report presents a conceptual framework and instructional information that scientifically describe the strengths and limitations of different approaches to record linkage of registries to other data sources. The report defines the requirements for high-quality record linkage of registries to other data sources and describes the strengths and limitations of different approaches. By explaining the spectrum of activities involved, it serves as an instructional guide for researchers designing new CER studies using patient registries linked with other secondary data sources. Through this report, we provide an overview of linkage from registries to administrative claims, including considerations for researchers, data managers, information technology managers, and other stakeholders who are likely to be involved in the process of data linkage. We also apply the data linkage framework to a real-world problem and discuss the results.




Encyclopedia of Health Services Research


Book Description

Today, as never before, healthcare has the ability to enhance the quality and duration of life. At the same time, healthcare has become so costly that it can easily bankrupt governments and impoverish individuals and families. Health services research is a highly multidisciplinary field, including such areas as health administration, health economics, medical sociology, medicine, , political science, public health, and public policy. The Encyclopedia of Health Services Research is the first single reference source to capture the diversity and complexity of the field. With more than 400 entries, these two volumes investigate the relationship between the factors of cost, quality, and access to healthcare and their impact upon medical outcomes such as death, disability, disease, discomfort, and dissatisfaction with care. Key Features Examines the growing healthcare crisis facing the United States Encompasses the structure, process, and outcomes of healthcare Aims to improve the equity, efficiency, effectiveness, and safety of healthcare by influencing and developing public policies Describes healthcare systems and issues from around the globe Key Themes Access to Care Accreditation, Associations, Foundations, and Research Organizations Biographies of Current and Past Leaders Cost of Care, Economics, Finance, and Payment Mechanisms Disease, Disability, Health, and Health Behavior Government and International Healthcare Organizations Health Insurance Health Professionals and Healthcare Organizations Health Services Research Laws, Regulations, and Ethics Measurement; Data Sources and Coding; and Research Methods Outcomes of Care Policy Issues, Healthcare Reform, and International Comparisons Public Health Quality and Safety of Care Special and Vulnerable Groups The Encyclopedia is designed to be an introduction to the various topics of health services research for an audience including undergraduate students, graduate students, andgeneral readers seeking non-technical descriptions of the field and its practices. It is also useful for healthcare practitioners wishing to stay abreast of the changes and updates in the field.




Beyond the HIPAA Privacy Rule


Book Description

In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.




Health Services Research and Analytics Using Excel


Book Description

Your all-in-one resource for quantitative, qualitative, and spatial analyses in Excel® using current real-world healthcare datasets. Health Services Research and Analytics Using Excel® is a practical resource for graduate and advanced undergraduate students in programs studying healthcare administration, public health, and social work as well as public health workers and healthcare managers entering or working in the field. This book provides one integrated, application-oriented resource for common quantitative, qualitative, and spatial analyses using only Excel. With an easy-to-follow presentation of qualitative and quantitative data, students can foster a balanced decision-making approach to financial data, patient statistical data and utilization information, population health data, and quality metrics while cultivating analytical skills that are necessary in a data-driven healthcare world. Whereas Excel is typically considered limited to quantitative application, this book expands into other Excel applications based on spatial analysis and data visualization represented through 3D Maps as well as text analysis using the free add-in in Excel. Chapters cover the important methods and statistical analysis tools that a practitioner will face when navigating and analyzing data in the public domain or from internal data collection at their health services organization. Topics covered include importing and working with data in Excel; identifying, categorizing, and presenting data; setting bounds and hypothesis testing; testing the mean; checking for patterns; data visualization and spatial analysis; interpreting variance; text analysis; and much more. A concise overview of research design also provides helpful background on how to gather and measure useful data prior to analyzing in Excel. Because Excel is the most common data analysis software used in the workplace setting, all case examples, exercises, and tutorials are provided with the latest updates to the Excel software from Office365 ProPlus® and newer versions, including all important “Add-ins” such as 3D Maps, MeaningCloud, and Power Pivots, among others. With numerous practice problems and over 100 step-by-step videos, Health Services Research and Analytics Using Excel® is an extremely practical tool for students and health service professionals who must know how to work with data, how to analyze it, and how to use it to improve outcomes unique to healthcare settings. Key Features: Provides a competency-based analytical approach to health services research using Excel Includes applications of spatial analysis and data visualization tools based on 3D Maps in Excel Lists select sources of useful national healthcare data with descriptions and website information Chapters contain case examples and practice problems unique to health services All figures and videos are applicable to Office365 ProPlus Excel and newer versions Contains over 100 step-by-step videos of Excel applications covered in the chapters and provides concise video tutorials demonstrating solutions to all end-of-chapter practice problems Robust Instructor ancillary package that includes Instructor’s Manual, PowerPoints, and Test Bank




An Introduction to Health Services Research


Book Description

This is a primary, comprehensive textbook for people who are considering undertaking a piece of health-related research. It is an accessible companion with the aim of getting the reader to think broadly about all of the issues that need to be considered when embarking on a project. This is a pragmatic book, a step-by-step guide to research which mirrors the structure of a research project, taking you through the thought process for designing and conducting your study from formulating the right research question at idea inception, ascertaining what methodologies and analysis can answer what type of questions, right through to dissemination, all presented in an easy, digestible style. The book is full of case study illustrations and practical tips such as how to work out a research budget and obtaining funding for your project, discussion of what permissions need to obtained when conducting research with people, and how to involve public and patients. The authors are all experienced researchers and so this book is an accumulation of collective wisdom on common research challenges and issues.




Methodological Developments in Data Linkage


Book Description

A comprehensive compilation of new developments in data linkage methodology The increasing availability of large administrative databases has led to a dramatic rise in the use of data linkage, yet the standard texts on linkage are still those which describe the seminal work from the 1950-60s, with some updates. Linkage and analysis of data across sources remains problematic due to lack of discriminatory and accurate identifiers, missing data and regulatory issues. Recent developments in data linkage methodology have concentrated on bias and analysis of linked data, novel approaches to organising relationships between databases and privacy-preserving linkage. Methodological Developments in Data Linkage brings together a collection of contributions from members of the international data linkage community, covering cutting edge methodology in this field. It presents opportunities and challenges provided by linkage of large and often complex datasets, including analysis problems, legal and security aspects, models for data access and the development of novel research areas. New methods for handling uncertainty in analysis of linked data, solutions for anonymised linkage and alternative models for data collection are also discussed. Key Features: Presents cutting edge methods for a topic of increasing importance to a wide range of research areas, with applications to data linkage systems internationally Covers the essential issues associated with data linkage today Includes examples based on real data linkage systems, highlighting the opportunities, successes and challenges that the increasing availability of linkage data provides Novel approach incorporates technical aspects of both linkage, management and analysis of linked data This book will be of core interest to academics, government employees, data holders, data managers, analysts and statisticians who use administrative data. It will also appeal to researchers in a variety of areas, including epidemiology, biostatistics, social statistics, informatics, policy and public health.




Sharing Clinical Trial Data


Book Description

Data sharing can accelerate new discoveries by avoiding duplicative trials, stimulating new ideas for research, and enabling the maximal scientific knowledge and benefits to be gained from the efforts of clinical trial participants and investigators. At the same time, sharing clinical trial data presents risks, burdens, and challenges. These include the need to protect the privacy and honor the consent of clinical trial participants; safeguard the legitimate economic interests of sponsors; and guard against invalid secondary analyses, which could undermine trust in clinical trials or otherwise harm public health. Sharing Clinical Trial Data presents activities and strategies for the responsible sharing of clinical trial data. With the goal of increasing scientific knowledge to lead to better therapies for patients, this book identifies guiding principles and makes recommendations to maximize the benefits and minimize risks. This report offers guidance on the types of clinical trial data available at different points in the process, the points in the process at which each type of data should be shared, methods for sharing data, what groups should have access to data, and future knowledge and infrastructure needs. Responsible sharing of clinical trial data will allow other investigators to replicate published findings and carry out additional analyses, strengthen the evidence base for regulatory and clinical decisions, and increase the scientific knowledge gained from investments by the funders of clinical trials. The recommendations of Sharing Clinical Trial Data will be useful both now and well into the future as improved sharing of data leads to a stronger evidence base for treatment. This book will be of interest to stakeholders across the spectrum of research-from funders, to researchers, to journals, to physicians, and ultimately, to patients.




Race, Ethnicity, and Language Data


Book Description

The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.




OECD Health Policy Studies Health Data Governance Privacy, Monitoring and Research


Book Description

This report identifies eight key data governance mechanisms to maximise benefits to patients and to societies from the collection, linkage and analysis of health data, and to minimise risks to both patient privacy and the security of health data.