Towards using administrative databases to measure population-based indicators of quality of end-of-life care: testing the methodology

TLDR

The study focuses on methods to measure population‑based indicators of quality end‑of‑life care. The study assesses the feasibility, validity, and reliability of using administrative databases to measure end‑of‑life care quality indicators in two Canadian provinces. The retrospective cohort included all female breast‑cancer deaths from 1998‑2002 in Nova Scotia and Ontario and examined 19 literature‑derived quality indicators, of which seven were fully measurable in both provinces and others partially measurable. Administrative data showed high agreement with chart data, confirming reliable abstraction, and proved to be an efficient, population‑based method for monitoring quality of care that complements other approaches.

Abstract

This study is concerned with methods to measure population-based indicators of quality end-of-life care. Using a retrospective cohort approach, we assessed the feasibility, validity and reliability of using administrative databases to measure quality indicators of end-of-life care in two Canadian provinces. The study sample consisted of all females who died of breast cancer between 1 January 1998 and 31 December 2002, in Nova Scotia or Ontario, Canada. From an initial list of 19 quality indicators selected from the literature, seven were determined to be fully measurable in both provinces. An additional seven indicators in one province and three in the other province were partially measurable. Tests comparing administrative and chart data show a high level of agreement with inter-rater reliability, confirming consistency in the chart abstraction process. Using administrative data is an efficient, population-based method to monitor quality of care which can compliment other methods, such as qualitative and purposefully collected clinical data.