Data Quality Documentation for External Users: National .Data Quality Documentation for External

  • View
    215

  • Download
    0

Embed Size (px)

Text of Data Quality Documentation for External Users: National .Data Quality Documentation for External

pic

pic pic

Standards and Data Submission

Data Quality Documentation for External Users: National Ambulatory Care Reporting System, 20102011

Who We AreEstablished in 1994, CIHI is an independent, not-for-profit corporation that provides essential information on Canadas health system and the health of Canadians. Funded by federal, provincial and territorial governments, we are guided by a Board of Directors made up of health leaders across the country.

Our VisionTo help improve Canadas health system and the well-being of Canadians by being a leading source of unbiased, credible and comparable information that will enable health leaders to make better-informed decisions.

Table of Contents Abbreviations ......................................................................................................... iii

1 Introduction ...................................................................................................... 1 1.1 Purpose and Scope ................................................................................ 1 1.2 An Overview of the National Ambulatory Care Reporting System .......... 1

2 Coverage ......................................................................................................... 5 2.1 Population of Reference for NACRS ....................................................... 5

3 Data Collection and Standards ........................................................................ 8 3.1 Data Collection ........................................................................................ 8 3.2 Data Quality Control .............................................................................. 10 3.3 Standardization ..................................................................................... 13 3.4 Linkage ................................................................................................. 14 3.5 Equivalency ........................................................................................... 16

4 Major Changes to NACRS ............................................................................. 16 4.1 Historical Comparability ........................................................................ 16

5 General Data Limitations ............................................................................... 19 5.1 Accuracy ............................................................................................... 19 5.2 Comparability ........................................................................................ 28

6 General Data Query Guidelines .................................................................... 30

Appendix A20102011 NACRS Data Elements Mandatory/Optional Status ... 31

Appendix BNACRS Field Evolution by Fiscal Year .......................................... 37

Appendix CIdentifying Duplicates in NACRS ................................................... 47

Bibliography ......................................................................................................... 49

Contacts .............................................................................................................. 50

iii

Data Quality Documentation for External Users: National Ambulatory Care Reporting System, 20102011

Abbreviations ACCS Ambulatory Care Classification System ADT admission/discharge/transfer AHP allied health professional Alta. Alberta B.C. British Columbia CACS Comprehensive Ambulatory Classification System CC cardiac catheterization (clinic) CCI Canadian Classification of Health Interventions CCO Cancer Care Ontario CCP Canadian Classification of Diagnostic, Therapeutic, and

Surgical Procedures CIHI Canadian Institute for Health Information CL clinic CSR client services representative CTAS Canadian Triage Acuity Scale DAA death after arrival DAD Discharge Abstract Database DI diagnostic imaging DOA death on arrival DPG Day Procedure Group DS day surgery ED emergency department EDIS emergency department information system eDSS electronic Data Submission Services eNACRS NACRS Electronic Comparative Reports HCN Health Care Number ICD-10-CA International Statistical Classification of Diseases and Related

Health Problems, 10th Revision, Canada ICD-9 International Statistical Classification of Diseases and Related

Health Problems, 9th Revision ICD-9-CM International Statistical Classification of Diseases and Related

Health Problems, 9th Revision, Clinical Modification LOS length of stay Man. Manitoba MED D/N medical day/night care MCR multiple contact record MIS FC Management Information System Functional Centre MOHLTC Ministry of Health and Long-Term Care (Ontario) NACRS National Ambulatory Care Reporting System

iv

Data Quality Documentation for External Users: National Ambulatory Care Reporting System, 20102011

NCAD National Clinical Administrative Databases (steering committee) N.S. Nova Scotia OC oncology clinic OMHRS Ontario Mental Health Reporting System Ont. Ontario PCCF Postal Code Conversion File (Statistics Canada) PCTAS Pediatric Canadian Triage Acuity Scale PDF printable document format P.E.I. Prince Edward Island PHAC Public Health Agency of Canada PIA Physician Initial Assessment Que. Quebec RD renal dialysis clinic SARS severe acute respiratory syndrome Sask. Saskatchewan TADB Therapeutic Abortions Database UCC urgent care centre Y.T. Yukon Territory

1

Data Quality Documentation for External Users: National Ambulatory Care Reporting System, 20102011

1 Introduction 1.1 Purpose and Scope This document provides background information on the National Ambulatory Care Reporting System (NACRS) and describes general data limitations that may influence analyses. The background and general data limitations chapters are organized into sections based on criteria outlined in CIHIs Data Quality framework.

To create an operational definition of data quality, CIHI defined five dimensions of data quality to divide fitness for use into distinct components. They are accuracy, timeliness, comparability, usability and relevance. This document examines accuracy and comparability using the June 2009 revision of the CIHI Data Quality Framework. This document focuses on accuracy and comparability. Accuracy refers to how well information in or derived from the database reflects the reality it was designed to measure. Comparability refers to the extent to which the database is consistent over time and uses standard conventions, making it comparable to other databases.

1.2 An Overview of the National Ambulatory Care Reporting System

As in many other developed countries, ambulatory care comprises a significant portion of the health care delivered in Canada. It has expanded significantly in recent years and is now one of the largest-volume patient activities in Canadian health care. As such, the need for high-quality, reliable and timely data about this sector is paramount. For this reason, the Canadian Institute for Health Information (CIHI) developed the National Ambulatory Care Reporting System (NACRS). This system is designed to provide valuable information that can help evaluate the management of ambulatory care services in Canadian health care facilities.

NACRS is a national database designed to capture information on client visits to facility- and community-based ambulatory care. Data about visits is collected at the time of service in participating facilities. Data elements in NACRS can be grouped according to five categoriesdemographic, clinical, administrative, financial and service-specificwith information on discharges, deaths and transfers within a fiscal year (April 1 to March 31). Over time, NACRS has been used to capture not only emergency department (ED) visits but also day surgery (DS) procedures, diagnostic imaging (DI) visits and numerous clinic visits, including renal dialysis (RD), cardiac catheterization (CC), oncology (OC) and mental health (MH).

More than 16.9 million abstracts were submitted to NACRS in 20102011. Of these, more than 8.2 million related to ED visits, representing approximately 51.8% of all ED visits in Canada. About 2.4 million day surgery abstracts were submitted to CIHI in 20102011, with 36.4% sent to the DAD and 63.6% sent to NACRS.

2

Data Quality Documentation for External Users: National Ambulatory Care Reporting System, 20102011

Following NACRS inception in 1997, when it was developed based on Albertas Ambulatory Care Classification System (ACCS) to collect information on ambulatory care, the product was re-engineered in 20022003 to respond to the Canadian implementation of the International Classification of Diseases, 10th Revision, and the Canadian Classification of Health Interventions (ICD-10-CA/CCI). In 20092010, the NACRS database was further modified to allow for different levels of data submission to reduce the burden of data collection and improve timelines for reporting purposes (see Section 4 for more details). In 20102011, NACRS implemented standard National Management Information System Functional Centre (MIS FC) Account Codes for use in NACRS and developed standard ambulatory care groups based on this national list (see sections 3.3 and 4 for more details). Furthermore, with additional jurisdictions adopting NACRS for ED reporting, it is anticipated that by 20122013, at least 80% of all ED visits in Canada will be reported to NACRS. Table 1 illustrates the evolution of NACRS.

Table 1: Timeline of NACRS Evolution, 20102011

NACRS Evolution April 1997 NACRS launched

First British Columbia facility adopts emergency department (ED) reporting July 2000 Ontario adopts ED reporting

April 2001 La