Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management



Measurement and monitoring of the quality of care using a core set of quality measures are increasing in health service research. Although administrative databases include limited clinical data, they offer an attractive source for quality measurement. The purpose of this study, therefore, was to evaluate the completeness of different administrative data sources compared to a clinical survey in evaluating rectal cancer cases.


Between May 2012 and November 2014, a clinical survey was done on 498 Lombardy patients who had rectal cancer and underwent surgical resection. These collected data were compared with the information extracted from administrative sources including Hospital Discharge Dataset, drug database, daycare activity data, fee-exemption database, and regional screening program database. The agreement evaluation was performed using a set of 12 quality indicators.


Patient complexity was a difficult indicator to measure for lack of clinical data. Preoperative staging was another suboptimal indicator due to the frequent missing administrative registration of tests performed. The agreement between the 2 data sources regarding chemoradiotherapy treatments was high. Screening detection, minimally invasive techniques, length of stay, and unpreventable readmissions were detected as reliable quality indicators. Postoperative morbidity could be a useful indicator but its agreement was lower, as expected.


Healthcare administrative databases are large and real-time collected repositories of data useful in measuring quality in a healthcare system. Our investigation reveals that the reliability of indicators varies between them. Ideally, a combination of data from both sources could be used in order to improve usefulness of less reliable indicators.

Post author correction




Carlo Corbellini, Bruno Andreoni, Luca Ansaloni, Giovanni Sgroi, Mario Martinotti, Ildo Scandroglio, Pierluigi Carzaniga, Mauro Longoni, Diego Foschi, Paolo Dionigi, Eugenio Morandi, Mauro Agnello, Lombardy Oncologic Network Work Group

Article History


Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.
Meeting presentation: Presented as an oral presentation at the Annual Conference of Italian Society of Surgery; Milan, Italy; 2015.

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  • Department of General Surgery, Rho Hospital, ASST Rhodense, Milan - Italy
  • Department of General Surgery, Istituto Europeo di Oncologia, Milan - Italy
  • General Surgery Recidency, University of Milan, Milan - Italy
  • Department of General Surgery, Azienda Ospedaliera Papa Giovanni XXIII, ASST-Papa Giovanni XXIII, Bergamo - Italy
  • Department of General Surgery, Treviglio Hospital, ASST di Bergamo, Bergamo - Italy
  • Department of General Surgery, Cremona Hospital, ASST Cremona, Cremona - Italy
  • Department of General Surgery, Busto Arsizio Hospital, - ASST Valle Olona, Varese - Italy
  • Department of General Surgery, Presidio Ospedaliero di Merate, ASST Lecco, Lecco - Italy
  • Department of General Surgery, Bassini Hospital, Cinisello Balsamo, ASST Nord Milano, Milan - Italy
  • Department of General Surgery, Azienda Ospedaliera Luigi Sacco, ASST Fatebenefratelli Sacco, Milan - Italy
  • Department of General Surgery, Fondazione IRCCS Policlinico San Matteo di Pavia, Pavia - Italy
  • General Surgery Recidency, University of Pavia, Pavia - Italy
  • Office of Improvement and Innovation at Lombardy Health Service Department, Lombardy - Italy

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