FEASIBILITY AND UTILITY OF ADDING DISEASE-SPECIFIC OUTCOME MEASURES TO ADMINISTRATIVE DATABASES TO IMPROVE DISEASE MANAGEMENT

To increase the utility of administrative databases, it has been recom mended that they include disease-specific, patient-centered outcome me asures. This paper reviews practical and theoretical considerations an d the critical evidence to support this recommendation. The strengths and weaknesses of the recommended approach are illustrated by examples of disease-specific measures for arthritis and musculoskeletal diseas es. Current experience suggests that routine capture of these measures in administrative databases has formidable practical problems and wou ld be unlikely to affect patient care. They could be used as gross ind icators of a population's experience but would be insensitive to clini cally meaningful improvement on the level of the individual patient. B y themselves, these measures are unlikely to identify actionable strat egies to improve outcomes, but they could improve efficiency. Overall, implementing this type of disease management improvement strategy wou ld have little value in direct patient care and would be costly.