Linking claims data and beneficiary survey information to report on the quality of health care: potential, pitfalls, and perspectives

• Published in: Gesundheitswesen (Bundesverband der Ärzte des Öffentlichen Gesundheitsdienstes (Germany)) Vol. 77; no. 2; p. e26
• Main Author: Bitzer, E M
• Format: Journal Article
• Language: German
• Published: Germany 01-02-2015
• Subjects: Data Accuracy; Germany; Health Care Surveys - methods; Health Care Surveys - standards; Health Care Surveys - statistics & numerical data; Hospital Information Systems - statistics & numerical data; Information Storage and Retrieval - methods; Information Storage and Retrieval - standards; Information Storage and Retrieval - statistics & numerical data; Insurance Benefits - statistics & numerical data; Insurance Claim Review - standards; Insurance Claim Review - statistics & numerical data; Meaningful Use - statistics & numerical data; Medical Record Linkage - methods; Medical Record Linkage - standards; National Health Programs - statistics & numerical data; Quality Assurance, Health Care - methods; Quality Assurance, Health Care - statistics & numerical data; Quality of Health Care - classification; Quality of Health Care - statistics & numerical data; Germany
• ISSN: 1439-4421
• DOI: 10.1055/s-0034-1395650

Reports on the quality of care aim at health and patient-reported outcomes in routine clinical care. To achieve meaningful information the study designs must be robust against bias through highly selected patient populations or health care providers but also allow for adequate control of confounding. The article describes the potential and pitfalls of administrative claims data and surveys of beneficiaries. The large potential of using both sources is illustrated in the primary inpatient treatment for prostate cancer. However, linking claims data and patient survey data still leaves some problems to be addressed in the final section. Linking claims data and beneficiary survey information on patient reported outcomes overcomes sectoral barriers and allows for an integrated evaluation of pathways of care in the short-, mid- and long-term. It is economical and well suited for a variety, but not all health care problems. Future efforts might be directed towards more collaboration among sickness funds.