Historically, users of information on the health system have relied heavily on private and statebased sources that complement federal efforts. Information on health system components, resources and structures has been maintained separately for health providers and health insurers. The focus has mainly been on information about discrete entities or individual providers rather than their characteristics or relationships with one another. Information on process of care has been based mainly on discharge/encounter level data for institutional services. Data from which outcome measures can be constructed have been highly limited.
We found that many but not all of the information needs and gaps cited in our study have been the focus of attention in previous studies, that preceded the current market changes. These studies include those by the National Committee for Vital and Health Statistics, the Institute of Medicine, the Health Care Financing Administration, and foundations particularly concerned with state data. The existing studies have focused on the inputs and outputs of care rather than on the way these inputs are organized and structured and the effects of these structures--a topic of considerable interest to many of those we spoke with in the private sector. Further, many of the needs identified in earlier studies remain today.