Overview of Swedish Quality Registries Bertil Lindahl Professor
Overview of Swedish Quality Registries Bertil Lindahl, Professor in Cardiology, Director of Uppsala Clinical Research center.
Knowledge based health care Pre-clinical research Clinical studies, including RCT. s Outcome research Selective implementation with systematic follow-up Role for Quality Registries Systematic reviews / guidelines Implementation in clinical routine, nationally and locally Follow up of outcome and sideeffects in clinical routine, nationally and locally
Quality registry – no new idea ”I am considered to be eccentric when I officially say that if the hospitals want to be certain to improve, they have to find out what results they have. They have to analyse their results to find strong and weak points. They have to compare their results with others. These opinions will not be eccentric in a couple of years”. Ernest Amory Codman MD 1917
History of Swedish Quality Registries Knäplastik; 1975 Höftplastikregistret; 1979 Kärlregistret; 1987 Oxygenregistret; 1987 Höftfrakturregistret; 1988 Pacemakerregistret; 1989 Registret för coronar angioplastik; 1990 Registret för aktiv uremivård; 1990
Swedish Quality Registries 2012 • 4 on level 1 73 registries covering • 20 on level 2 a wide range of different interventions and diseases • 49 on level 3 • 27 candidates to become certified registries
Three different categories of registries 1. ”interventions”, eg. hip arthroplasty operation or heart surgery 2. ”diagnosis – based on an episode of a certain acute disease”, eg. myocardial infarction or stroke 3. ”diagnosis – chronic diseases”, eg. diabetes or rheumatoid arthritis
The strategisk styrgrupp operativ beslutsgrupp. expertgrupp referensgrupper Currently ≈70 National Q. Registries
Summary
National Quality Registries UCR Patient record Electronic Patient Record National Health Data Registries Biobanking UCR Data Warehouse UCR research db Publications
SCAAR Data entry on line by the phycians SWEDE and nurses HEART
SCAAR On-line reports SWEDE HEART
Proportion of AMI patients reaching LDL target level one year after AMI
The use of registries for Research
• Cardiovascular and cancer mortality in very elderly postmyocardial infarction patients receiving statin treatment. J. Am. Coll. Cardiol. 2010; 55(13): 1362 -9. • Eptifibatide is noninferior to abciximab in primary percutaneous coronary intervention: results from the SCAAR. J. Am. Coll. Cardiol. 2010; 56(6): 470 -5. • Gender perspective on risk factors, coronary lesions and long-term outcome in young patients with ST-elevation myocardial infarction. Heart. 2010; 96(6): 453 -9. • Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries. Cardiovascular Interventions. Eur. Heart J. 2010; 31(8): 943 -57. • Assessing the cost effectiveness of using prognostic biomarkers with decision models: case study in prioritising patients waiting for coronary artery surgery. BMJ. 2010 Jan 19; 340: b 5606.
Different aspects • Cardiovascular and cancer mortality in very elderly postmyocardial infarction patients receiving statin treatment. J. Am. Coll. Cardiol. 2010; 55(13): 1362 -9. • Eptifibatide is noninferior to abciximab in primary percutaneous coronary intervention: results from the SCAAR. J. Am. Coll. Cardiol. 2010; 56(6): 470 -5. • Gender perspective on risk factors, coronary lesions and long-term outcome in young patients with ST-elevation myocardial infarction. Heart. 2010; 96(6): 453 -9. • Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries. Cardiovascular Interventions. Eur. Heart J. 2010; 31(8): 943 -57. • Assessing the cost effectiveness of using prognostic biomarkers with decision models: case study in prioritising patients waiting for coronary artery surgery. BMJ. 2010 Jan 19; 340: b 5606.
Underutilization of quality registries for health economic studies
Costs were assigned using official statistical sources or market prices. Annual costs amounted to US$ 7666 per patient.
Thank you!
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