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Development of consistent health care information has been hampered by the lack of a core data set that contains clinical information. The Uniform Hospital Discharge Set was developed to record individual discharge profiles derived from hospital billing systems. Using that information, some states developed data repositories. Government and health insurers maintain databases of claims paid. The data are not consistent, not readily available, may not contain all encounters, and are financial, not clinical. Wide variance in number of procedures in different geographic regions, variability in mortality rates, and variance in expenditures for particular conditions have been identified from those databases. However, they contain little information to assess the 'best' clinical practices regarding patient outcome. We describe specific limitations of current data sets and how health services research, outcomes research, and policy research, could be improved by a core data set, as well as recommendations about a core data set. |
