BackgroundClinical auditing is an emerging instrument for quality assessment and improvement. Moreover, clinical registries facilitate medical research as they provide ‘real world’ data. It is... Show moreBackgroundClinical auditing is an emerging instrument for quality assessment and improvement. Moreover, clinical registries facilitate medical research as they provide ‘real world’ data. It is important that entered data are robust and reliable. The aim of this study was to describe the evolving procedure and results of data verification within the Dutch Institute for Clinical Auditing (DICA).MethodsData verification performed on several (disease-specific) clinical registries between 2013 and 2015 was evaluated. Sign-up, sample size and process of verification were described. For each procedure, hospitals were visited by external data managers to verify registered data. Outcomes of data verification were completeness and accuracy. An assessment of the quality of data was given per registry, for each participating hospital. Using descriptive statistics, analyses were performed for different sections within the individual registries.ResultsSeven of the 21 registries were verified, involving 174 visits to hospital departments. A step-by-step description of the data verification process was provided. Completeness of data in the registries varied from 97·2 to 99·4 per cent. Accuracy of data ranged from 88·2 to 100 per cent. Most discrepancies were observed for postoperative complications (0·7–7·5 per cent) and ASA classification (8·5–11·4 per cent). Data quality was assessed as ‘sufficient’ for 145 of the 174 hospital departments (83·3 per cent).ConclusionData verification revealed that the data entered in the observed DICA registries were complete and accurate. Show less
Govaert, J.A.; Fiocco, M.; Dijk, W.A. van; Kolfschoten, N.E.; Prins, H.A.; Dekker, J.W.T.; ... ; Dutch Value Based Hlthcare 2017
Objective: To compare actual 90-day hospital costs between elective open and laparoscopic colon and rectal cancer resection in a daily practice multicenter setting stratified for operative risk.... Show moreObjective: To compare actual 90-day hospital costs between elective open and laparoscopic colon and rectal cancer resection in a daily practice multicenter setting stratified for operative risk. Background: Laparoscopic resection has developed as a commonly accepted surgical procedure for colorectal cancer. There are conflicting data on the influence of laparoscopy on hospital costs, without separate analyses based on operative risk. Methods: Retrospective analyses using a population-based database (Dutch Surgical Colorectal Audit). All elective resections for a T1-3N0-2M0 stage colorectal cancer were included between 2010 and 2012 in 29 Dutch hospitals. Operative risk was stratified for age (<75 years or 75 years) and ASA status (I-II/III-IV). Ninety-day hospital costs were measured uniformly in all hospitals based on time-driven activity-based costing. Results: Total 90-day hospital costs ranged from s10474 to s20865 in the predefined subgroups. For colon cancer surgery (N.4202), laparoscopic resection was less expensive than open resection in all subgroups, savings because of laparoscopy ranged from s409 (<75 years ASA I-II) to s1932 (75 years ASA I-II). In patients 75 years and ASA I-II, laparoscopic resection was associated with 46% less mortality (P . 0.05), 41% less severe complications (P < 0.001), 25% less hospital stay (P . 0.013), and 65% less ICU stay (P < 0.001). For rectal cancer surgery (N.2328), all laparoscopic subgroups had significantly higher total hospital costs, ranging from s501 (<75 years ASA I-II) to s2515 ( 75 years ASA III-IV). Conclusions: Laparoscopic resection resulted in the largest cost reduction in patients over 75 years with ASA I-II undergoing colonic resection, and the largest cost increase in patients over 75 years with ASA III-IV undergoing rectal resection as compared with an open approach. Keywords: colorectal cancer, hospital costs, laparoscopy, population based registry, resection, tumor Show less
