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Overview of Swedish Quality Registries

Overview of Swedish Quality Registries. Bertil Lindahl, Professor in Cardiology, Director of Uppsala Clinical Research center. Role for Quality Registries. Knowledge based health care. Outcome research. Pre-clinical research . Clinical studies, including RCT.s .

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Overview of Swedish Quality Registries

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  1. Overview of Swedish Quality Registries Bertil Lindahl, Professor in Cardiology, Director of Uppsala Clinical Research center.

  2. Role for Quality Registries Knowledge based health care Outcome research Pre-clinical research Clinical studies, including RCT.s Selective implementation with systematic follow-up Systematic reviews / guidelines Implementation in clinical routine, nationally and locally Follow up of outcome and side-effects in clinical routine, nationally and locally

  3. Quality registry – no new idea ”I am considered to be eccentric when I officially say that if the hospitals want to be certain to improve, they have to find out what results they have. They have to analyse their results to find strong and weak points. They have to compare their results with others. These opinions will not be eccentric in a couple of years”. Ernest Amory Codman MD 1917

  4. History of Swedish Quality Registries • Knäplastik; 1975 • Höftplastikregistret; 1979 • Kärlregistret; 1987 • Oxygenregistret; 1987 • Höftfrakturregistret; 1988 • Pacemakerregistret; 1989 • Registret för coronar angioplastik; 1990 • Registret för aktiv uremivård; 1990

  5. 73registries covering a wide range of different interventions and diseases • Swedish Quality Registries 2012 • • 4 on level 1 • • 20 on level 2 • • 49 on level 3 • • 27 candidates to become certified registries

  6. Three different categories of registries • ”interventions”, eg. hip arthroplasty operation or heart surgery • ”diagnosis – based on an episode of a certain acute disease”, eg. myocardial infarction or stroke • ”diagnosis – chronic diseases”, eg. diabetes or rheumatoid arthritis

  7. The strategisk styrgrupp operativ beslutsgrupp. expertgrupp referensgrupper Currently ≈70 National Q. Registries

  8. Summary

  9. National Quality Registries Biobanking UCRPatientrecord UCRData Warehouse Electronic PatientRecord UCRresearch db NationalHealthDataRegistries Publications

  10. SCAAR SWEDE HEART Data entry on line by the phycians and nurses

  11. SCAAR SWEDE HEART On-line reports

  12. Proportion of AMI patients reaching LDL target level one year after AMI

  13. The use of registries for Research

  14. Cardiovascular and cancer mortality in very elderly post-myocardial infarction patients receiving statin treatment. J. Am. Coll. Cardiol. 2010;55(13):1362-9. • Eptifibatide is noninferior to abciximab in primary percutaneous coronary intervention: results from the SCAAR . J. Am. Coll. Cardiol. 2010;56(6):470-5. • Gender perspective on risk factors, coronary lesions and long-term outcome in young patients with ST-elevation myocardial infarction. Heart. 2010;96(6):453-9. • Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries. Cardiovascular Interventions. Eur. Heart J. 2010;31(8):943-57. • Assessing the cost effectiveness of using prognostic biomarkers with decision models: case study in prioritising patients waiting for coronary artery surgery. BMJ. 2010 Jan 19;340:b5606.

  15. Different aspects • Cardiovascular and cancer mortality in very elderly post-myocardial infarction patients receiving statin treatment. J. Am. Coll. Cardiol. 2010;55(13):1362-9. • Eptifibatide is noninferior to abciximab in primary percutaneous coronary intervention: results from the SCAAR . J. Am. Coll. Cardiol. 2010;56(6):470-5. • Gender perspective on risk factors, coronary lesions and long-term outcome in young patients with ST-elevation myocardial infarction. Heart. 2010;96(6):453-9. • Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries. Cardiovascular Interventions. Eur. Heart J. 2010;31(8):943-57. • Assessing the cost effectiveness of using prognostic biomarkers with decision models: case study in prioritising patients waiting for coronary artery surgery. BMJ. 2010 Jan 19;340:b5606.

  16. Underutilization of quality registries for health economic studies

  17. Costs were assigned using official statistical sources or market prices. Annual costs amounted to US$ 7666 per patient.

  18. Thank you!

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