Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. NCVHS Reports


Standing committees that oversee the National Center for Health Statistics’ (NCHS) data collection activities have issued periodic reports, which tend to be technical in focus. The most relevant is a recent report (US DHHS 1996) recommending a standardized set of health data elements for capturing person- and encounter-level information. The set includes 42 elements, 12 of which are person level. Twenty-six elements were viewed as being ready for immediate implementation, 10 as being substantially ready, and the rest as requiring much work. The impetus for NCVHS’s work is a concern about the administrative burden of inconsistency in data collection and reporting activities and about the confusion generated by lack of standardized health data definitions. Current and potential uses for the data cited in US DHHS (1996) include:

  • Clinical uses (clinical management and continuous quality improvement)
  • Payment- and cost-related uses (payment, cost containment, purchasing)
  • Management (planning and budgeting, assessing staffing needs, resource allocation, system reform and change)
  • Oversight (performance measurement, ensuring access, utilization review, profiling of physician practice patterns, assessing quality and outcomes)
  • Technology assessment (need for technology and its effectiveness)
  • Public health (surveillance, appraisal of practice)
  • Analysis (risk selection and adjustment, building episodes, sample frame development, health services research and epidemiology)
  • Consumer information (plan, provider and treatment choice, education)

NCVHS efforts to develop standardized person- and encounter-level data do not appear to have focused on the impact of the changing marketplace on individual data elements. For example, the payer and charge information included is relatively traditional and fee-for-service based.

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