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

Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax and Division of Medical Oncology, Dalhousie University, Halifax, eva.grunfeld{at}ccns.nshealth.ca

Lynn Lethbridge

Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax

Ron Dewar

Surveillance and Epidemiology Unit, Cancer Care Nova Scotia, Halifax

Beverley Lawson

Department of Family Medicine, Dalhousie University, Halifax

Lawrence F Paszat

Institute of Clinical Evaluative Sciences, University of Toronto, Toronto

Grace Johnston

Surveillance and Epidemiology Unit, Cancer Care Nova Scotia, Halifax and School of Health Services Administration, Dalhousie University, Halifax

Frederick Burge

Department of Family Medicine, Dalhousie University, Halifax

Paul McIntyre

Division of Palliative Medicine, Dalhousie University, Halifax

Craig C Earle

Division of Population Sciences, Dana-Farber Cancer Institute, Boston

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.

Key Words: health services • palliative care • quality indicators

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