1. Improving Data Recording in Primary Care Data Michelle Page & Hassy Dattani THIN

2. The Health Improvement Network Joint venture with Cegedim (InPS) Create a new primary care data source Improve quality of data recording Feedback service to GPs Help GPs to recognise value of Vision

3. Benefits to GPs of Joining THIN Free general training sessions on aspects of Vision supported by THIN Payment –Cash –Equivalent amount in training vouchers Free verification of back up tape Contribution to valuable public health research

4. THIN Data Population based data - 5% UK population Practices geographically representative of England and Wales Anonymised at source Simple flat file structure Regularly updated Collection scheme approved by MREC

5. Patient Records Patient identifier Year of birth (month also included for children) identifier shared by patients living at same address Sex of patient Patients registration date with the practice Date of transfer out of practice (if applicable)

6. Medical Records Patient identifier Event date Read medical code Variable indicating origin of record Episode type Secondary care speciality

7. Therapy Records Patient identifier Prescription date Multilex drug code DOSAGE instruction string Quantity prescribed Daily dosage evaluation

8. Additional Health Data Records Immunisations Blood pressure Test results Smoking Height and weight

9. Background & Importance New GP Contract –greater emphasis on quality of clinical care –can be demonstrated through data recording –practices provide high quality care but not reflected in data recording –data quality linked to financial benefits to practice NSF compliance

10. Study Objective To investigate the feasibility of independently assessing and reporting on specific criteria in GP data in order to improve quality (completeness) of recording of clinical information –comparing data from THIN GPs with national statistics and other THIN contributors –specifically for demography, death and diabetes

11. Method Demography (128 practices) –Age gender profile of all active patients by practice for 2001 only Death (128 practices) –All patients registered with a practice for a calendar year (1985 to 2001) including death within year transferred out of practice due to death + a medical record entry of death

12. Method Diabetes (154 practices) –Study period: 15 months prior to last collection date –Base population: registered for entire study period or died during –Diabetic population: at least two records indicating diabetes at any time those with treatment but no medical record entry –Evidence of quality indicators taken from GP contract and NSF measured during study period

13. Indicators Measured for Diabetes Smoking record (and smoking advice) Urine dipstick test (glucose, protein etc.) HbA1C BMI, blood pressure Cholesterol Serum creatinine, fructosamine Eye test, foot check

14. Results - Demography

15. Results – Death Recording

16. Results - Diabetes

19. Conclusion GP Data can be independently assessed to measure completeness of data recording Demographic profile of THIN practices is consistent with UK population Data recording in non-GPRD practices within THIN is of a similar quality to that in GPRD practices in some cases

20. Conclusion THIN practices will benefit from training provided by THIN THIN analysis can be used by GPs to identify patients requiring follow up in order to meet standards within GP contract and NSF

21. Further Research Compare recording in THIN practices with a control group to assess validity of THIN feedback to GPs Ongoing analysis of data collected from THIN practices – –Asthma –Coronary heart disease

22. Contact……. michelle.page@thin-uk.com hassy.dattani@thin-uk.com www.thin-uk.com