AHRQ has initiated a research program that awarded eight grants in September 2010 to improve statewide all-payer, hospital-based encounter-level data (inpatient, emergency department, and ambulatory surgery) for the purpose of both producing the evidence base for comparative effectiveness and evaluating efforts to implement comparative effectiveness where the evidence already exists. Two types of grants have been implemented under this research program to improve state data by:
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Clinical Content Enhancement
Five grantees will broaden and supplement their existing population-based data with hospital-based electronic pharmacy data, clinical laboratory data, prehospital emergency care data, clinical registries, and vital record birth and death certificates.
Florida Investigators at the University of South Florida are leveraging a strong collaborative partnership among many of Florida's key health care entities to create a statewide enhanced maternal–infant database of clinical and nonclinical information derived from birth and death vital records, as well as inpatient, ambulatory, and emergency department data. The end product will be tested by conducting a comparative effectiveness research study using early-term elective delivery as a case study. The database will serve as a sustainable tool for research, quality improvement, and enhancement of overall health, and as a model for other states with similar objectives. To date, the Florida project has:
Hawaii Collaborators from The Queen's Medical Center and Hawaii Health Information Consortium are enhancing the clinical content of Hawaii's statewide hospital discharge database by adding laboratory results and have furthered development of a master patient identifier to link and track patients across hospitals throughout the state. The researchers will demonstrate the viability of the enhanced database by performing a comparative effectiveness research study to examine the outcomes of care for patients treated by hospitalists compared with patients treated by nonhospitalists. The end result will be an enduring infrastructure that will improve research and quality. The Hawaii grant has begun to achieve many of its goals; it has:
Minnesota The Minnesota Hospital Association (MHA), in collaboration with Michael Pine Associates and the Mayo Clinic Division of Health Care Policy and Research, is augmenting the current MHA clinically enhanced administrative hospital discharge database with laboratory data from additional hospitals, and is introducing hospital pharmacy data and Minnesota death certificate data to the database. The end goal of the project is to use these data to facilitate rich comparative effectiveness analysis and to enhance the scope and quality of the Minnesota hospital discharge database. To date, the project has:
New Jersey An innovative partnership between academic researchers at Rutgers Center for State Health Policy an the New Jersey Department of Health and Senior Services is creating a data infrastructure that bridges prehospital and hospital care using electronic patient care records for emergency medical services transports in New Jersey. These data are being linked to all-payer hospital discharge data and death certificates to support a wide range of studies on interventions that involve prehospital and hospital services. A comparative effectiveness study of outcomes after provision of therapeutic hypothermia for initial survivors of out-of-hospital cardiac arrest will illustrate the value of the data. The project has:
New York The New York State (NYS) Department of Health; School of Public Health, SUNY–Albany; and Michael Pine Associates are working together to link administrative data from NYS' Statewide Planning and Research Cooperative System (SPARCS) acute care hospital discharge database to laboratory test results from facilities that perform coronary artery bypass graft (CABG) surgery or elective percutaneous coronary interventions (PCI). To assess the value of the resulting clinically enhanced database, the research team will compare comparative riskadjusted outcomes and analyses of the appropriateness of alternative revascularization procedures using the clinically enhanced administrative database with analyses performed using specialized CABG and PCI registries. Another goal of the project is to determine whether laboratory test results will enhance the ability of the cardiac registry data to riskadjust patient outcomes. The project has reached a number of milestones:
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Race and Ethnicity Data Improvement
Three grantees are improving the validity, reliability, and detail of patient race and ethnicity data which will generate better data for comparative effectiveness research to improve health care outcomes, including less disparate outcomes for different racial and ethnic groups.
California Investigators from the University of California, Los Angeles, in collaboration with the California Office of Statewide Health Planning and Development (OSHPD), are improving the reliability, validity, and completeness of self-reported race, ethnicity, and primary language (R/E/L) provided by hospitals in three OSHPD databases. The project has assessed data collection, reporting, and accuracy in California hospitals; is benchmarking the data against six comparison states; and will improve hospital race, ethnicity, and primary language data via development of standardized materials, educational intervention, auditing, and followup. The researchers will link OSHPD databases to other state agency data and use statistical approaches to authenticate their efforts. The project will make substantial, sustainable improvements to the reporting of R/E/L among patients in California's hospitals. The project has:
New Mexico The New Mexico Department of Health is improving the quality of race and ethnicity data in hospital discharge and emergency department databases by revising the New Mexico administrative code to mandate race, ethnicity, and tribal identifier data reporting. Specific goals include: improving patient race and ethnicity data in the New Mexico Hospital Inpatient Discharge Data; collecting tribal identifier data; evaluating the quality of race and ethnicity data; and sharing methods, tools, and procedures with other states. The project has:
Oregon/Washington/Idaho Using the most complete roster of Northwest American Indian/Alaska Native (AI/AN) people available, the Improving Data & Enhancing Access-Northwest (IDEA-NW) Project of the Northwest Portland Area Indian Health Board is conducting record linkages with an array of health-related data systems in a three state region to identify and, in some cases, augment racial misclassification and improve disease/mortality estimates. Thus far, the project has:
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Internet Citation: Data Innovations. Healthcare Cost and Utilization Project (HCUP). November 2012. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/datainnovations/grants.jsp. |
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Last modified 11/15/12 |