Creating a General (Family) Practice Epidemiological Database in Ireland - Data Quality Issue Management

摘要

In Ireland, while detailed information is available regarding hospital attendance, little is known regarding general (family) practice attendance. However, it is conservatively estimated that there are almost nine times as many general practice encounters than there are hospital encounters each year in Ireland. This represents a very significant gap in health information. Indeed, general practice has been shown in other countries to be an important and rich source of information about the health of the population, their behaviors and their utilization of health services. Funded by the Health Information and Quality Authority (HIQA), the Irish College of General Practitioners (ICGP) undertook a feasibility study of diagnostic coding of routinely entered patient data and the creation of a national general practice morbidity and epidemiological database (GPMED project). This article outlines the process of data quality issue management undertaken. The study's findings suggest that the quality of data collection and reporting structures available in general practice throughout Ireland at the outset of this project were not adequate to permit the creation of a database of sufficient quality for service planning and policy or epidemiological research. Challenges include the dearth of a minimum standard of data recorded in consultations by GPs and the absence of the digital data recording and exporting infrastructure within Irish patient management software systems. In addition, there is at present a lack of recognition regarding the value of such data for patient management and service planning--including importantly, data collectors who do not fully accept the merit of maintaining data, which has a direct consequence for data quality. The work of this project has substantial implications for the data available to the health sector in Ireland and contributes to the knowledge base internationally regarding general practice morbidity data.