Best Information through Regional Outcomes (BIRO): a decentralised - - PowerPoint PPT Presentation

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Best Information through Regional Outcomes (BIRO): a decentralised approach for the secure integration of performance indicators and the automated analysis of practice variation

Fabrizio Carinci

Professor of Health Systems and Policy School of Health Sciences, University of Surrey Member of the OECD Expert Group on Health Care Quality Indicators

f.carinci@surrey.ac.uk S e s s i

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I I R e d u c i n g U n w a r r a n t e d G e

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r a p h i c a l V a r i a t i

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3 : , 1 5

t h

A p r i l 2 1 6

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Reporting on medical practice variation

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Measurement vs Routine Monitoring P r

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e c t S y s t e m

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Choosing the reference model

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An inspiring statistical refmection

Complete Sample Combinations of Levels of Covariates Same results !

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EU BIRO and EUBIROD projects

B I R O p r

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e c t ( 2 5

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k s a n d t h e s y s t e m a t i c u s e

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t h e B I R O s y s t e m i n 2 E u r

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e a n c

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n t r i e s ”

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S y s t e m . F e d e r a t i

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k s s h a r i n g a c

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m

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d i s t r i b u t e d h e a l t h i n f

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S t a t i s t i c a l O b j e c t . E l e m e n t

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a d i s t r i b u t e d i n f

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s y s t e m c a r r y i n g e s s e n t i a l d a t a i n t h e f

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i n t e r e s t D a t a s

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BIRO fundamental principles

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Data sources vs population-based analysis

Numerator

• Denominator

Total Population (Region) Catchment Area People with Diabetes

DATA

INDICATORS

OUTCOMES

“Active” Patients (Centre)

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C

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d u c t a P r i v a c y I m p a c t A s s e s s m e n t R e v i e w y

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t w a r e A n a l y s e d a t a a n d d i s s e m i n a t e r e s u l t s T r a n s f e r t e c h n

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y E v a l u a t e , i m p r

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The BIRO approach

2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9 10 10

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T h e s t r u c t u r e

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d i s e a s e r e g i s t e r s : i d e a l v s r e a l

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The BIRO system

http://www.eubirod.eu

L i n k e d D a t a b a s e # 1 L

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a l R e p

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t S t a t i s t i c a l A n a l y s i s A g g r e g a t e T a b l e s

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Applying BIRO in the EUBIROD project: National decentralised automated reporting

I T A L Y : B I R O i n s t a l l e d i n N = 8 c e n t r e s ; S . E . = S t a t i s t i c a l E n g i n e D A T A B A S E S O F I N D I V I D U A L R E C O R D S S T A Y WI T H T H E O R I G I N A L D A T A C U S T O D I A N

Italian Report EU Report Central Engine Repository of Italian Aggregates (Statistical Objects) Statistical Objects from other countries Central Engine Italian Society of Diabetology Regional Aggregates

Centre Report

S.E.

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EUBIROD Report (2012)

8/2/2012: New BIRO Release 2.1.12 15/2/2012: Collection of statistical objects closed 21/2/2012: EU Report available (N=79 indicators) 13 Days from Software Release to Online Publication of the results !

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G l y c a t e d H a e m

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l

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i n ( H b A 1 c )

N = 1 6 8 , 9 4 8

E U B I R O D D i a b e t e s R e p

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t 2 1 2

Type 1 Type 2 Other Type

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Application of the BIRO approach to the NEO system in the Matrice project (Agenas 2011-2014)

h t t p s : / / g i t h u b . c

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H R s H E S . . . L

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t D a t a b a s e E n g i n e C e n t r a l S e r v e r G l

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t D a t a L i n k a g e A g g r e g a t e L H A s ( R e g i

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NEO Software Open Source Tools adopted The shaded data architecture is based on the BIRO system (2005-2012, see www.biro-project.eu, www.eubirod.eu)

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N e

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t p u t s

h t t p s : / / g i t h u b . c

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/ a g e n a s / n e

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O E C D H e a l t h I n f

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I n f r a s t r u c t u r e , H

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p i t a l P e r f

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m a n c e B e n c h m a r k i n g

Diabetes EUBIROD Diabetes Report

User Technical

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Wa t c h t h i s s p a c e !

B I R O h t t p : / / w w w . b i r

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U B I R O D N E T WO R K h t t p : / / w w w . h i r s

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T h a n k s f

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Guildhall clock, Guildford, Surrey, UK