Making the best use of administrative data

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1284 (Published 27 February 2013) Cite this as: BMJ 2013;346:f1284
  1. Adam Steventon, senior research analyst
  1. 1Nuffield Trust, London W1G 7LP, UK
  1. adam.steventon{at}nuffieldtrust.org.uk

The difficulty of teasing out demand and supply

Making better use of routine administrative data is becoming an ever more integral part of delivering higher quality more efficient healthcare. Routine data are useful when evaluating complex interventions related to the management of patients with long term conditions, which need continuous monitoring and refinement.1 Other applications of routine data are predictive models, which have been developed to identify patients at high risk of future adverse events.2 Finally, payment mechanisms almost inevitably use (and generate) routine data, and routine data are the basis for many performance indicators.3

Problems with routine data are well known. They often do not tell us everything we need to know (for example, wider determinants of health), they rarely capture the direct views of patients and do not always correlate well with what patients tell us,4 they vary in quality and depth of data, and they can be “gamed.”5 Furthermore, as pointed out in a linked paper by Wennberg and colleagues (doi:10.1136/bmj.f549), it can be challenging to separate out healthcare need from supply in analyses of …

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