Measurement of medical outcome quality using administative data in Germany

While internationally low-effort reporting and quality assurance systems based on routine data for hospitals were implemented a long time ago, the evaluation of the treatment quality in hospitals according to 137 SGB V in Germany still relies on special data collection, which demands considerable extra time and effort for the healthcare providers. The current article starts by addressing the question whether quality analyses using primary data sources should be preferred to analyses using secondary data analyses. Subsequently, current possibilities of measuring outcome quality, using administrative routine data, will be illustrated, referring to the large collaborative project Quality Assurance of Hospital Care with Routine Data (QSR). This project was carried out in order to examine possibilities of measuring quality based on routine administrative data in Germany from 2002-2007. The objectives of this article are to present a summary of the project's current status as well as to provide perspectives of future quality assurance with routine data in Germany. In addition, some general problems in measurement of outcome quality, the volume-prevalence problem and the problem of risk adjustment are presented, and possible solutions are proposed.