Provider-Level and Hospital-Level Factors and Process Measures of Quality Care Delivered in Pediatric Emergency Departments

Marcin, James P.; Romano, Patrick S.; Dayal, Parul; Dharmar, Madan; Chamberlain, James M.; Dudley, Nanette C.; Macias, Charles G.; Nigrovic, Lise E.; Powell, Elizabeth C.; Rogers, Alexander; Sonnett, Meridith; Tzimenatos, Leah; Andrews-Dickert, Rebecca; Borgialli, Dominic; Sidney, Erika; Casper, T. Charles; Kuppermann, Nathan

doi:10.1016/j.acap.2019.11.007

Cited by 3 publications

(1 citation statement)

References 35 publications

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“… 4 Although appropriate in many situations, there may be circumstances in which this recruitment and data collection approach is not appropriate or optimal—for example, when the centralized EHR sampling frame is not representative of the target population resulting in limited generalizability 3 , 5 , 6 or when the study objectives include testing HCF-level predictors across multiple HCFs. 7 , 8 Under such circumstances, other methods are required to acquire a more representative sample of the target population or to obtain data from patients receiving care at multiple HCFs.…”

Section: Introductionmentioning

confidence: 99%

Procurement of patient medical records from multiple health care facilities for public health research: feasibility, challenges, and lessons learned

et al. 2023

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Objectives Studies that combine medical record and primary data are typically conducted in a small number of health care facilities (HCFs) covering a limited catchment area; however, depending on the study objectives, validity may be improved by recruiting a more expansive sample of patients receiving care across multiple HCFs. We evaluate the feasibility of a novel protocol to obtain patient medical records from multiple HCFs using a broad representative sampling frame. Materials and Methods In a prospective cohort study on HIV pre-exposure prophylaxis utilization, primary data were collected from a representative sample of community-dwelling participants; voluntary authorization was obtained to access participants’ medical records from the HCF at which they were receiving care. Medical record procurement procedures were documented for later analysis. Results The cohort consisted of 460 participants receiving care from 122 HCFs; 81 participants were lost to follow-up resulting in 379 requests for medical records submitted to HCFs, and a total of 343 medical records were obtained (91% response rate). Less than 20% of the medical records received were in electronic form. On average, the cost of medical record acquisition was $120 USD per medical record. Conclusions Obtaining medical record data on research participants receiving care across multiple HCFs was feasible, but time-consuming and resulted in appreciable missing data. Researchers combining primary data with medical record data should select a sampling and data collection approach that optimizes study validity while weighing the potential benefits (more representative sample; inclusion of HCF-level predictors) and drawbacks (cost, missing data) of obtaining medical records from multiple HCFs.

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