Year of Publication

2006

Document Type

Dissertation

College

Business and Economics

Department

Business Administration

First Advisor

Clyde W. Holsapple

Abstract

This dissertation describes a case study comparing the effectiveness of twoinformation systems that assess the quality of surgical care, the National SurgicalQuality Improvement Program (NSQIP) and the University HealthSystemConsortium Clinical Database (UHCCD). For the comparison, it develops aframework for assessing contextual data quality (CDQ) from the decision maker'sperspective. The differences in quality assessment systems to be studied areposited to be due to the differing contexts in which the data is encoded,transformed and managed impacting data quality for the purpose of surgicalquality assessment.Healthcare spending in the United States has risen faster than the rate of inflationfor over a decade and currently stands at about fifteen percent of the GrossDomestic Product. This has brought enormous pressures on the healthcareindustry to reduce costs while maintaining or improving quality. Numeroussystems to measure healthcare quality have been, and are being, developedincluding the two being studied. A more precise understanding of the differencesbetween these two systems' effectiveness in the assessment of surgical healthcarequality informs decisions nationally regarding hospital accreditation and qualitybasedreimbursements to hospitals.The CDQ framework elaborated is also applicable to executive informationsystems, data warehouses, web portals, and other information systems that drawinformation from disparate systems. Decision makers are more frequently havingdata available from across functional and hierarchical areas within organizationsand data quality issues have been identified in these systems unrelated to thesystem performance from which the data comes.The propositions explored and substantiated here are that workgroup contextinfluences data selection and definition, the data entry and encoding process,managerial control and feedback, and data transformation in information systems.These processes in turn influence contextual data quality relative to a particulardecision model.The study is a cross-sectional retrospective review of archival quality datagathered on 26,322 surgical patients at the University of Kentucky Hospital alongwith interviews of process owners in each system. The quality data includepatient risk/severity factors and outcome data recorded in the National SurgeryQuality Improvement Program (NSQIP) database and the UniversityHealthSystem Consortium Clinical Database (UHCCD).

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