A survey of Australian clinical registries: can quality of care be measured?

Background: Clinical quality registries gather and analyse information to monitor and enhance the quality of care received by patients. The aim of the present study was to determine the attributes of Australian clinical registries to identify their capacity to accurately assess quality of care. Methods: A survey was distributed to registry custodians managing multi-site clinical outcome registries. They were asked to self-report on general aspects of registries, including coverage, length of operation, data collection process, data management, quality of data and registry governance structures. Results: A total of 28 registries were identified and all provided responses to the survey. The majority of the registries require modifications to their procedures in order to provide useful and reliable information for quality improvement purposes. Thirteen registries (46%) did not assess or recruited fewer than 80% of the eligible population and 23 (82%) did not formally audit reliability of coding at the clinical level. Five (18%) did not collect the information required for basic risk adjustment of outcome measures. While most registries produced reports for providers and interested parties, the approach to disseminating this information was highly variable. Conclusion: Clinical registries provide the most credible information about quality of care. However, most key registries in Australia require some adaptation of procedures in order to accomplish this task. Funding should be provided to enable registries to make the necessary changes.