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Protocol for analysis of root causes of problems affecting the quality of the DRG-based hospital data: A rapid review and Delphi process
The DRG-based administrative hospital database is an important tool for hospital financing in several health systems. It is also an important source of data for clinical, epidemiological and health services research. Therefore, the quality of the data included in these databases is of utmost importance since quality deficiency can cause problems during the exploitation of the data. To avoid or to solve these problems, it is paramount to identify the root causes of the lack of quality in the data. In order to do this process easier, data quality analysts could benefit from having a catalog of potential root causes to explore. Unfortunately, literature has not covered this concern extensively, what motivated us to research. This paper presents a protocol for the analysis of root causes that may affect the quality of these data. The proposed protocol includes two stages: (1) a systematic review to extract root causes from the scientific literature, and (2) a Delphi technique to analyze the relevance of root causes and to map them into data quality dimensions. Moreover, we provide a pilot study based on a systematic review covering papers published during 2018 and 2019. This aimed to establish proof of concept of the proposed methodology and to examine its feasibility. Eighteen studies were included for data charting, rendering 70 root causes. The Ishikawa framework provided a meaningful way to represent the root causes. Most of these causes were associated with people's knowledge, education and processes performed in the making or treatment of the data.