Research archive: Vol. 31 No.2

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Volume 31 Number 2: >> Quality in health care

	Outcome data and quality: The critical role of policy Russell Renhard [ PDF ] Abstract Health outcomes data are a major focus of the Australian health policy debate and the national research agenda. There is general agreement that health outcomes data should be collected. Outcomes data have been shown to be a powerful stimulant to service quality at the clinical level. It is argued here that policy which places health outcomes data at the centre of resource allocation and competitive cost control strategies is likely to undermine its capacity to stimulate quality at the clinical level. Policy is needed to support the role of health outcomes data so that it is relevant to clinicians and is seen as being fundamental to quality improvement processes at the organisational level. Governments and other funding bodies require that services be accountable for the quality of their services. By using health outcomes data this quality guarantee can be based on evidence that the data are analysed routinely and, where appropriate, clinical services are modified and improved. Without this clear role for health outcomes data, they may become yet another 'top-down' accountability tool that has little relevance to clinicians and therefore loses its value as a stimulant to quality improvement.
	Experience with coding accuracy for endophthalmitis Jonathon Ng, Jianghong Li, Nigel Morlet and James Semmens [ PDF ] Abstract The Endophthalmitis Population Study of Western Australia aims to investigate the epidemiology of endophthalmitis, a potentially sight-threatening infection of the internal eye, in Western Australia in 1980–1998. Cases of endophthalmitis were identified from coded hospital discharge data, surgeon logbooks, and hospital microbiology and anaesthetic databases. This process uncovered not only widespread miscoding for endophthalmitis, but also systematic misuse of the endophthalmitis codes for external eye infections. The level of miscoding and code misuse has improved since the mid-1990s, and probably reflects the introduction of coding standards and trained coders into the Western Australian health system.