Governmental agencies collect and analyze individually identifiable health information as part of their efforts to improve public policies and program management, improve health care and reduce costs, and improve information available for consumer choices. Governments use the information to analyze health care outcomes, quality, costs and patterns of utilization, effects of public policies, changes in the health care delivery system, and related trends. These important purposes are related to public health, research and oversight (although the information in State or other governmental data systems usually is not collected specifically to audit or evaluate health care providers or for public health surveillance). The data are an important resource that can be used for multiple public policy evaluations.
The collection of health information by governmental health data systems often occurs without specification of the particular analyses that could be conducted with the information. These governmental data collection programs frequently call for reporting of information for all individuals treated or released by specified classes of providers. For example, many States request and receive from hospitals records containing individual diagnosis and treatment data for all discharges from their facilities. State hospital discharge data have been used to compare treatment practices and costs between hospitals, to evaluate implications for funding of health care, as well as to provide hospital “report cards” to consumers. As part of its general evaluation activities, the DOD maintains a very large database, called the Comprehensive Clinical Evaluation Program, involving military personnel who have reported illnesses possibly arising from service during the Gulf War.