- Administrative health data recorded for individual health episodes (such as births, deaths, physician visits, and hospital stays) are being widely used to study policy-relevant scientific questions about population health, health services, and quality of care.
- Administrative health data serve as a tool for: population health research, health service performance analysis, quality of care, disease surveillance.
- Furthermore, an increasing number of international health comparisons are being undertaken with these data by agencies such as the World Health Organization (WHO), the Organization for Economic Cooperation and Development (OECD), and the World Bank.
- An essential pre-requisite to such international comparative work is a detailed characterization of existing international health data resources, so that they can be used more readily in comparison studies across counties, including Canada, the United States and developing countries.
- A major challenge to such international comparative work is the variability across countries in the extent, content, and validity of existing administrative data holdings.
- Recognizing this, we have undertaken an international collaborative process of compiling detailed data about data – i.e., a “meta-data catalogue” – for existing international administrative health data holdings. The methodological process for collecting these meta-data is described here, along with some general descriptive results for selected countries.
The Information Paradox
- The WHO has defined the “information paradox” as the existing disparity of high quality health information often lacking in the countries with the highest burdens of disease and the highest need for easily accessible, high quality health information.
- The creation of an online open access compendium of existing international health data sources, on a country-by-country basis, including detailed information on existing administrative health data holdings to facilitate data access and to inform applied uses.
- To create an invaluable tool for researchers and organizations interested in accessing information from many countries.
- The ultimate project goal agreed to with the WHO is to compile metadata on all officially listed countries in the world.
- To provide foundational work detailing and cataloguing existing health information in both developed and developing countries with the long term goal of health system improvement.
- To foster a community of international collaborators amongst researchers, policy makers and others to help create, improve and maintain this tool moving forward, in addition assist with knowledge translation and dissemination.
- Our ‘global health metadata catalogue’ (GHMC) is being developed collaboratively under the auspices of the International Methodology Consortium for Coded Health Information (IMECCHI – see http://www.imecchi.org).
- Data of interest includes: administrative accounts of codified individual level health care encounters.
- Data are being collected from a diverse combination of sources including: health insurance registries, inpatient care, day surgery, physician services, homecare, vital statistics and others.
- The databases of interest are national-level databases describing individual care encounters and/or health episodes recorded using any of a number of coding systems (i.e. ICD 9-CM, ICD 10, SNOMED).
- Using a combination of the Internet, telephone interviews, e-mail, written correspondence, and document analysis, we have gathered ‘metadata’ in three distinct layers in a relational database that is viewable by users on the Internet (www.imecchi.org).
- The database is relational such that information in deeper layers collapses upward to higher layers, sometimes with multiple items in the deeper layers.
- Layer 1 of the database consists of simple contact information on national-level agencies or individuals who hold coded health data.
- Layer 2 provides a nominal description for each individual dataset held by any given agency.
- Layer 3 consists of any supporting documents or validity elements that further describe the databases identified.
- For information-rich countries we have observed that it is possible to populate all 3 layers of the metadata-database. In contrast, for many developing countries, only information is available for layer 1.