national health data collections
DESCRIPTION
National Health Data Collections. – completeness, quality, timeliness, availability Presentation to Massey University’s Centre for Public Health Research Simon Ross Information Group, National Health Board 8 May 2012. Overview. What are the National Collections - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/1.jpg)
National Health Data Collections
– completeness, quality, timeliness, availability
Presentation to Massey University’s Centre for Public Health Research
Simon Ross
Information Group, National Health Board
8 May 2012
1
![Page 2: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/2.jpg)
Overview1. What are the National Collections
2. Where National Collections sit in the current MoH structure
3. Purpose and characteristics
4. Types of collections – high level overview
5. Completeness, quality, timeliness and availability
6. Who to contact for data requests and queries about the data
2
![Page 3: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/3.jpg)
What are the National Collections• A national repository of health information collected and
maintained by the Ministry of Health
• Split into ~ 14 individual collections
• Held in the Ministry of Health’s data warehouse and accessible to some users directly and to a much wider group by request
• Often the initial rationale for a collection was for a payment, funding or monitoring purpose, but the information collected serves many purposes including research
• Information can be linked to the same patient across collections
• Not included – Health Survey data
3
![Page 4: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/4.jpg)
Structural change – from NZHIS to NCR
New Zealand Health Information Service (NZHIS)
• disestablished 2008
National Collections and Reporting (NCR)
• Part of the Information Group in the National Health Board (NHB)
4
Public Health Intelligence (PHI) Health and Disability Intelligence (HDI)
![Page 5: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/5.jpg)
National Collections & Reporting (NCR)Group Manager – Tracey Vandenberg
5 Teams:
1. Data Management, National Collections
2. Classification & Terminology
3. Analytical Services
4. Statistics & Reporting
5. Projects
5
![Page 6: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/6.jpg)
The 6 uses of data principleCollect once, use many times:
• Supporting self-management
• Supporting clinical intervention
• Clinical governance
• Administration (in all parts of health)
• Strategy and policy development
• Research
6
![Page 7: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/7.jpg)
National Collections - characteristicsPerson-centred – NHIs on all records
Multiple uses – (‘collect once, use many times’)
A mix of information available
• Administrative
• Demographic
• Geographical
• Clinical
• Financial
7
![Page 8: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/8.jpg)
National Collections – here they are:
DHB Collections• National Minimum Dataset (NMDS)
• National Booking Reporting System (NBRS)
• National Non-Admitted Patient Collection (NNPAC)
• PRIMHD – mental health data
Registries• New Zealand Cancer Registry (NZCR)
• National Immunisation Register
• Mortality Collection
Primary Care Collections• Laboratory Claims Collection
• Pharmaceutical Collection
• General Medical Subsidy Collection
• Primary Health Organisation Enrolment Collection
Other• National Maternity Collection
• Medical Warning System
• National Health Index
• Health Practitioners Index
8
![Page 9: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/9.jpg)
National Minimum Dataset (NMDS)
Hospital discharge event data from all DHBs (~1,000,000 events per annum)
Hospital events from many private hospitals (130,00 events per annum)
Clinical coding applied to all events (ICD-10-AM)
Coded diagnosis, procedure and external cause detail
Up to 99 codes able to be reported per event
Coded data augmented with free text in some cases
Year ends 30 June
9
![Page 10: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/10.jpg)
Private Hospitals dataDischarge event data from >300 private hospitals/facilities
Reporting not mandatory (except publicly funded events)
• data are incomplete
• some large surgical hospitals don’t report
Quality of diagnosis information report often poor – procedures information is better
Data loaded into NMDS
Availability
• Affected by completeness
• published along with public hospital NMDS data
10
![Page 11: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/11.jpg)
Mortality Collection – information sourcesData from 1988 (but statistics from earlier years are available)
BDM Death and Stillbirth registrations – core datasets
Causes of death information• Medical certificates of cause of death• Coroners reports• Postmortem reports• Hospital events in NMDS• New Zealand Cancer Registry (NZCR)• Land Transport NZ, Water Safety NZ
11
![Page 12: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/12.jpg)
Mortality Collection – continuedUnderlying cause of death – on all records
Specific contributing causes:• Diseases including diabetes mellitus, alcoholism, HIV &
others• Injuries (from 1999 onwards)• All causes for 0-24 years (from 2010)
Dynamic database • Each year’s data is published once a determination is
made that most salient data has been received• Updates are applied if subsequent relevant
information is received• Coroner’s decisions are the primary reason for
updates12
![Page 13: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/13.jpg)
New Zealand Cancer Registry (NZCR)Data from 1948, Cancer Registry Act 1993 & Regulations 1994
All new cancers diagnosed in NZ
Information sources:
• Pathology & haematology reports from Labs
• Other National Collections (NMDS / Mortality Collection)
ICD-10-AM cancer ‘site’ codes, ICD-O morphology
Timeliness:
• Specialist ‘sites’ – coded within 3 months of notification (respiratory, breast, melanoma, prostate, cervix, colorectal, haematology/lymphatic, 0-24 yrs)
• General release ~18 months after year of reference
13
![Page 14: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/14.jpg)
Collection – who provides the data?Local
• GPs, pharmacies, laboratories, NGOs, LMCs, private hospitals
Regional
• DHBs, PHOs
National (government agencies)
• Department of Internal Affairs, Coronial Services
14
![Page 15: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/15.jpg)
ExamplesNMDS
• DHBs, private hospitals
PRIMHD
• DHB secondary mental health services, NGOs
Maternity
• LMC claims, NMDS
• mother-baby links from up to three sources (hospitals, claims, registrations)
Mortality
• Registrations – Department of Internal Affairs
• Cause of death – coroners, death certificates, post mortem reports, NMDS, NZCR, more
15
![Page 16: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/16.jpg)
What do the collections contain?• A patient identifier (NHI numbers)
• Demographics
• Geographic locators (meshblocks, domicile codes, TLA, DHB)
• Dates of service
• Clinical information (varying levels of clinically relevant data)
• Administrative data
• Financial data (varying levels and sources)
16
![Page 17: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/17.jpg)
Contents discussion (examples)Varying levels of clinical information
• NMDS vs NNPAC
• Pharms: medications but not conditions
• Labs: tests but not test results
• PRIMHD: services provided / team information but limited diagnosis and outcomes information at this point
Varying levels and sources of financial information
• NMDS vs NNPAC
• Pharms vs Labs (estimates)
• PHO (capitation), GMS (fee for service)
17
![Page 18: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/18.jpg)
Completeness
Variable and collection specific
Completeness does affect our release policy for certain collections
For example:
• NMDS (public vs private)
• Pharms (community dispensed and subsidised vs hospital)
• Maternity (LMC claims data vs DHB provided services)
• NHI reporting to labs and pharms – improvements over time
18
![Page 19: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/19.jpg)
Completeness – example
NHI reporting (pharms)Claim year Year HCU %
2001 0.0%
2002 25.6%
2003 43.7%
2004 63.9%
2005 86.5%
2006 92.2%
2007 94.3%
2008 95.4%
2009 95.8%
NHI reporting (labs)Claim year Year HCU %
2001 66.7%
2002 73.5%
2003 82.0%
2004 87.9%
2005 90.9%
2006 92.1%
2007 93.9%
2008 95.5%
2009 96.8%
19
![Page 20: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/20.jpg)
Quality - general
Quality and completeness are closely related
Quality can vary based on many factors, for example:
• The source of the data
• The maturity of the collection
• The method and location of data collection, coding and entry
This is not a exhaustive list
20
![Page 21: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/21.jpg)
A selection of quality-related concepts• Compliance
• Business rules
• Opportunities for re-submission
• Master NHIs: merge, unmerge, overlays
• Geocoding
• Applying aggregate measures to individuals: NZDep
• Challenges of using claims data – the impact of purpose of collection on the quality of information submitted
• The effect of incentives on patterns of coding and data submission
• Examples: NMDS coding (public vs. private), maternity data quality
21
![Page 22: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/22.jpg)
Timeliness
Submission times
• DHB collections – monthly
• Claims collections – ad hoc (but with limits)
• Mortality – dependent on the data source
• Cancer – dependent on the source of diagnosis and the data element
22
![Page 23: National Health Data Collections](https://reader033.vdocument.in/reader033/viewer/2022051118/56816769550346895ddc5135/html5/thumbnails/23.jpg)
AvailabilityControlled release collections
• Mortality and cancer
Provisional data
Identifiable > encrypted > non-identifiable > aggregate
Who to contact?
• Team Leader, Analytical Services, 04 816 2893
23