ABOUT THE SERIES DIRECTIONS IN HEALTH SERVICES RESEARCH AND POLICY -- FOREWORD -- FIGURES -- TABLES -- ACKNOWLEDGMENTS -- INTRODUCTION -- WHAT DO STAKEHOLDERS WANT TO KNOW? -- WHAT IS WRONG WITH CURRENT HEALTH SYSTEM INFORMATION? -- BUILDING AN INTEGRATED INFORMATION SYSTEM -- DATA SOURCES FOR AN INTEGRATED INFORMATION SYSTEM -- WHAT KIND OF DATA SHOULD AN INTEGRATED INFORMATION SYSTEM INCLUDE? -- What Questions Do Stakeholders Want Answered? -- When Do Stakeholders Need Answers? -- What Are the Consequences of Acting on Inaccurate Information? -- WHEN IS EXPERT HELP REQUIRED? -- DATA SOURCES FOR AN INTEGRATED INFORMATION SYSTEM -- ENROLLMENT DATA -- Uses of Enrollment Data -- Problems with Existing Enrollment Data -- ADMINISTRATIVE DATA -- Uses of Administrative Data -- Problems with Existing Administrative Data -- CLINICAL DATA -- Uses of Clinical Data -- Problems with Existing Clinical Data -- SURVEY DATA -- Uses of Survey Data -- Problems with Survey Data -- OTHER DATA SOURCES -- STRATEGIES FOR IMPROVING THE UTILITY OF INTEGRATED INFORMATION SYSTEMS -- FOR MORE DETAIL -- WHAT CONSUMERS OF RESEARCH NEED TO KNOW ABOUT ANALYSIS -- FORMULATING THE QUESTION -- DESIGNING THE STUDY -- IDENTIFYING THE DATA SOURCE -- CONSTRUCTING THE ANALYSIS FILE -- Restricting the File to a Subset of Individuals -- Selecting Variables -- Merging Data from Different Sources -- Initial Data Quality Checks -- SELECTING AN APPROPRIATE ANALYTIC TECHNIQUE -- INTERPRETING THE RESULTS -- FOR MORE DETAIL -- THINKING STRATEGICALLY ABOUT INFORMATION SYSTEMS -- DESCRIPTION OF DATA SOURCES AND RELATED ISSUES -- INTRODUCTION -- DATA SOURCES: EXISTING SYSTEMS -- Administrative Data -- Enrollment Data -- Clinical Data -- Survey Data -- Other Data Sources -- PROBLEMS AND POTENTIAL SOLUTIONS TO IMPROVE THE UTILITY OF HEALTH DATA SYSTEMS.

Lack of Unique Identifiers for Linking Purposes -- Varying Levels of Data Quality -- Nonuniformity of Data Elements Across Different Data Systems -- Enhancements to the Existing Set of Data Elements -- GENERAL ANALYSIS ISSUES -- FORMULATING THE QUESTION -- DESIGNING THE STUDY -- IDENTIFYING THE DATA SOURCE -- CONSTRUCTING AN ANALYSIS FILE -- Restricting the File to a Subset of Individuals -- Selecting Variables -- Merging Data from Different Sources -- Initial Data Quality Checks -- A SAMPLER OF ANALYTIC TECHNIQUES -- Description -- Inference -- a, -- b -- Prediction -- INTERPRETING THE RESULTS -- DEVELOPING AND USING A CLINICAL INFORMATION SYSTEM -- INTRODUCTION -- HOW WILL A CLINICAL INFORMATION SYSTEM WORK? -- HOW DO CLINICAL DATA DIFFER FROM ADMINISTRATIVE DATA? -- WHY IS SEVERITY ADJUSTMENT IMPORTANT? -- WHAT ARE THE CHARACTERISTICS OF AN IDEAL CLINICAL INFORMATION SYSTEM? -- Diagnoses Must Be Valid -- Data Must Be Uniform and Consistent -- Data Must Allow for Severity or Risk Adjustment -- Data Must Be Entered in "Real Time" -- The Information System Must Contain Unique Identifiers for Patients and Providers -- Data Must Be Comprehensive -- USING CLINICAL DATA TO ADJUST FOR DIFFERENCES IN SEVERITY -- WHAT ARE THE POTENTIAL USES OF A CLINICAL INFORMATION SYSTEM? -- Quality of Care -- Access to Care -- Costs and Cost-Effectiveness -- Performance of Health Plans and Providers -- Effect of Public Health Programs -- Effect of Policy Changes on Health -- Disease Surveillance -- Rate/Premium Setting -- DECIDING WHAT CONDITIONS TO TARGET -- Common Conditions -- Limitations in Function -- Common Procedures -- Ambulatory Care -- WHAT TARGET CONDITIONS SHOULD BE INCLUDED? -- DETAILED EXAMPLES FOR TWO TARGET CONDITIONS Breast Cancer Screening -- Treatment of Coronary Artery Disease -- ADDITIONAL TARGET CONDITIONS FOR CONSIDERATION.

Preventive/Screening Services -- Treatment of Chronic Conditions -- Procedures -- CAN A CLINICAL INFORMATION SYSTEM ANSWER ALL CLINICAL QUESTIONS? -- AN OVERVIEW OF METHODS FOR CONDUCTING SURVEYS -- INTRODUCTION -- DESIGNING AND CONDUCTING A SURVEY -- SAMPLING THE STUDY POPULATION Methods of Sampling -- Choosing a Sample Size -- MODES OF SURVEY ADMINISTRATION -- CROSS-SECTIONAL, LONGITUDINAL, AND REPEATED CROSS-SECTIONAL DESIGNS -- CONTENT OF THE SURVEY -- Preliminary Steps in Choosing Survey Questions -- Questionnaire Construction -- Question Order -- IMPLEMENTING THE SURVEY Introduction and Instruction -- Maximizing Response Rates -- WHO SHOULD ADMINISTER THE SURVEY? -- AN OVERVIEW OF RISK ADJUSTMENT -- INTRODUCTION -- WHAT IS RISK ADJUSTMENT? -- WHAT FACTORS SHOULD BE CONSIDERED FOR RISK ADJUSTMENT? -- WHY IS RISK ADJUSTMENT IMPORTANT? -- HOW IS RISK ADJUSTMENT USED? -- Setting Private Health Insurance Premiums -- Establishing Hospital Payment Rates for Medicare -- Determining Capitated Risk Contracts -- Profiling the Performance of Providers -- HOW IS A RISK-ADJUSTMENT SYSTEM EVALUATED? -- Strength of Predictions -- Incentives for Inefficient Care -- Ease of Collecting Data -- Ease of Audit and Gaming the System -- WHAT CAN BE DONE TO AUGMENT PROSPECTIVE RISK ADJUSTMENT? -- WHAT WORK IS BEING DONE TO IMPROVE THE ABILITY TO RISK- ADJUST? -- Predicting Costs Based on Prior Hospitalization -- Predicting Outpatient Care Costs -- WHAT IS SEVERITY ADJUSTMENT? -- WHY IS SEVERITY ADJUSTMENT IMPORTANT? -- HOW IS SEVERITY ADJUSTMENT USED? -- When Is Severity Adjustment Necessary? -- What Factors Should Be Considered for Adjustment? -- What Data Sources Are Available for Severity Adjustment? -- HOW TO CHOOSE A SEVERITY-ADJUSTMENT SYSTEM -- MedisGroups (Original Version) -- Computerized Severity Index.

Managed Health Care Association Outcomes Management System Project -- Type II Diabetes Patient Outcomes Research Team Project -- ABOUT THE AUTHORS -- BIBLIOGRAPHY -- GLOSSARY -- SOURCES USED TO COMPLETE GLOSSARY:.