Overview of Swedish Quality Registries

Bertil Lindahl, Professor in Cardiology,Director of Uppsala Clinical Research center.

Selective implementation with systematic follow-upClinical studies, including RCT.s Systematic reviews / guidelines Pre-clinicalresearch Follow up of outcome and side-effects in clinical routine, nationally and locallyImplementation in clinical routine, nationally and locallyKnowledge based health careOutcome research

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 1917Quality registry no new idea

History of Swedish Quality Registries Knplastik; 1975 Hftplastikregistret; 1979 Krlregistret; 1987 Oxygenregistret; 1987 Hftfrakturregistret; 1988 Pacemakerregistret; 1989 Registret fr coronar angioplastik; 1990 Registret fr aktiv uremivrd; 1990

Swedish Quality Registries 2012

4 on level 1 20 on level 2 49 on level 3

27 candidates to become certified registries

73 registries covering a wide range of different interventions and diseases

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

Currently 70 NationalQ. Registries Thestrategisk styrgrupp operativ beslutsgrupp.expertgrupp referensgrupper

Summary

National Quality RegistriesUCR Patient recordElectronic Patient RecordUCR Data WarehouseUCR research dbPublicationsNational Health Data Registries

Data entry on line by the phyciansand nurses

On-line reports

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

The use of registries for Research

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.

Different aspectsCardiovascular 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.

Underutilization of quality registries for health economic studies

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

Thank you!

**There is a number of prepared reports that the user can select directly on-line. *It is also possible to se mortality in the on-line reports. Here is mortality in relation to Diabetes status. The bars illustrates the one year mortality in my own hospital and in the whole contry. This is unadjusted Kaplan-Meier curves at Akademiska hospital and in all hospitals together.