Administrative databases and clinical governance: The case of COPD

Int J Health Plann Manage. 2019 Jan;34(1):177-186. doi: 10.1002/hpm.2609. Epub 2018 Aug 16.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. However, COPD is still underdiagnosed, undertreated, and not sufficiently prevented. Health administrative databases provide a powerful way of studying COPD in the population.

Methods: This retrospective study used administrative data, collected during 2011 and 2012, retrieved from 3 Italian local health authorities (LHAs).

Results: The analysis through administrative databases allowed firstly to identify patients with COPD receiving services by the 3 LHAs: The estimated average is ~3% of the population aged ≥40 years. Furthermore, it was also possible to stratify patients by investigating the health consumption in hospitalization for COPD and use of respiratory drugs. In all 3 LHA patients with moderate COPD were the majority of the population with COPD. Finally, it was possible to distinguish patients who made an appropriate use of SABA (76% of the total), patients who had a potentially inappropriate use (20%), and those with an overuse of SABA (4%).

Conclusion: The use of SABA consumption patterns can be a reliable proxy variable to detect subgroups who may necessitate therapy revision. Health administrative databases seem beneficial for planning health care interventions, including the COPD field. They are robust information systems subjected to regular data quality controls remaining the prevalent data source, reliable because of the amount of data and the population coverage, especially in countries with a National Health Service System.

Keywords: COPD management; administrative database; appropriateness and disease control; population health management; short-acting beta-agonists (SABA).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Clinical Governance*
  • Databases, Factual*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Care Management
  • Population Health
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive* / drug therapy
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Pulmonary Disease, Chronic Obstructive* / prevention & control
  • Research
  • Retrospective Studies

Grants and funding