Analysis of root causes of problems affecting the quality of hospital administrative data: A systematic review and Ishikawa diagram

Roberto Carvalho*, Mariana Lobo, Mariana Oliveira, Ana Raquel Oliveira, Fernando Lopes, Júlio Souza, André Ramalho, João Viana, Vera Alonso, Ismael Caballero, João Vasco Santos, Alberto Freitas

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

15 Citations (Scopus)

Abstract

Introduction: Administrative hospital databases represent an important tool for hospital financing in many national health systems and are also an important data source for clinical, epidemiological and health services research. Therefore, the data quality of such databases is of utmost importance. This paper aims to present a systematic review of root causes of data quality problems affecting administrative hospital data, creating a catalogue of potential issues for data quality analysts to explore. Methods: The MEDLINE and Scopus databases were searched using inclusion criteria based on two following concept blocks: (1) administrative hospital databases and (2) data quality. Studies’ titles and abstracts were screened by two reviewers independently. Three researchers independently selected the screened studies based on their full texts and then extracted the potential root causes inferred from them. These were subsequently classified according to the Ishikawa model based on 6 categories: ”Personnel”, “Material”, “Method”, “Machine”, “Mission” and “Management”. Results: The result of our investigation and the contribution of this paper is a classification of the potential (105) root causes found through a systematic review of the 77 relevant studies we have identified and analyzed. The result was represented by an Ishikawa diagram. Most of the root causes (25.7%) were associated with the category “Personnel” – people's knowledge, preferences, education and culture, mostly related to clinical coders and health care providers activities. The quality of hospital documentation, within category “Material”, and aspects related to financial incentives or disincentives, within category “Mission”, were also frequently cited in the literature as relevant root causes for data quality issues. Conclusions: The resultant catalogue of root causes, systematized using the Ishikawa framework, provides a compilation of potential root causes of data quality issues to be considered prior to reusing these data and that can point to actions aimed at improving data quality.

Original languageEnglish
Article number104584
JournalInternational Journal of Medical Informatics
Volume156
DOIs
Publication statusPublished - Dec 2021
Externally publishedYes

Keywords

  • Administrative hospital data
  • Clinical coding
  • Data quality
  • Data quality issue root cause

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