Health services researchers often use administrative and claims datasets in their research because they contain large populations, offer reliable periodicity of collection and release, have consistently reported and standardized data elements, and are relatively inexpensive and easy to obtain and use. Although a limited number of patient outcomes such as hospital readmission rates, emergency department visits, and in-hospital mortality are available in databases containing administrative claims data, linking administrative claims with data from patient registries and other sources of detailed clinical data can facilitate comparative effectiveness research by allowing for a more comprehensive examination of patient outcomes and risk factors. More thorough and accurate analyses can result from linking administrative data to other types of clinical health data such as laboratory, pharmacy, emergency medical services, and vital statistics data.

In addition to benefiting the research community, related improvements to health data infrastructure provide benefits to the healthcare organizations themselves, such as more accurate performance reporting, and increased capacity to handle, store, and manipulate data. In spite of these potential benefits, there are significant barriers to linking these data, including differing data standards and formats, conflicting laboratory test and prescription coding systems, patient privacy concerns, and difficulty hiring IT vendors with sufficient expertise.

This toolkit provides an overview of the various steps involved in initiating and executing data-enhancement projects, including project initiation and planning, staff training and relevant tools, and the process of collecting various types of clinical data and linking these data to administrative datasets, and managing the linked databases.

The web page and publications presented below discuss the rationale for and benefits of enhancing the clinical content of administrative databases.

Additional Background on Making the Case for Clinical Data Enhancement from the Laboratory Data Toolkit on Enhancing the Clinical Content of Administrative Data

"Enhancement of Claims Data to Improve Risk Adjustment of Hospital Mortality"

(Pine et al., 2007, Journal of the American Medical Association)

"Combining Administrative and Clinical Data to Stratify Surgical Risk"

(Fry et al., 2007, Annals of Surgery)

"Cost-Effective Enhancement of Claims Data to Improve Comparisons of Patient Safety"

(Harmon et al., 2007, Journal of Patient Safety)

"Modifying ICD-9-CM Coding of Secondary Diagnoses to Improve Risk-adjustment of Inpatient Mortality Rates"

(Pine et al., 2009, Medical Decision Making)