Standardized data sets can serve many purposes in the current and future health care arena. In the evolving managed care field, the need to follow individuals through a continuum of care and at multiple sites will become increasingly necessary. Performance monitoring and outcomes research are two areas that are currently hampered by the inability to link data sets from various sources.
Standardized data sets, starting with the UHDDS developed by the NCVHS, have been in use for more than two decades. There has been substantial agreement on data elements in these sets, but less agreement on data definitions. In addition, these efforts have concentrated on individual sites of care, ie., hospital inpatient, physician office, and nursing home, which, until recently, were the traditional sites of most care. In recent years, the focus of health care has been shifting to hospital outpatient and other outpatient care, including clinic, hospice and home care, sites for which standardized data collection had not been developed. The transference of data sets from the traditional sources has not fully met the needs of these sites. Additionally the move in the health care payment system to managed care has increased the need to be able to link data sets and individual records across time, facility, and broader geographic locations. Thus to meet the needs for standardized data, movement must be made toward standardized definitions for those data sets that are already in use, and for an increased use of standardized data elements and definitions by those data collection efforts for which no current standardized data sets exist.
The data sets that are currently standardized are prime examples of satisfying multiple purposes with a single data set. With the use of UHDDS-defined data, for example, state and private abstracting systems have been providing comparable state and local data for health planners for many years. These same data bases are being used to provide input to Federal surveys such as the National Hospital Discharge Survey (NCHS) and the Hospital Cost and Utilization Project (AHCPR). However, AHCPR is in the process of publishing findings indicating definitional discrepancies even within the organizations collecting the UHDDS.