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Linking Hospital Discharge Summaries from Oncology Departments in Order to Achieve Epidemiological Cancer Monitoring for Strategic Planning

Author(s): Trombert-Paviot B | Martin C | Quantin C | De Laroche G | Rodrigues J-M

Journal: Revue médicale de l'assurance maladie
ISSN 0767-2004

Volume: 32;
Issue: 3;
Start page: 235;
Date: 2001;
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Keywords: oncology service | health planning | DRG | data bases linkage | encryption | cancer registries

In anticipation of the creation of a cancer institute (ICL) in Saint-Etienne, France, 3 hospitals tested a procedure which permanently links hospital discharge summaries to DRG’s (PMSI). To this end used the asymmetric hashing and encrypting software developed by one of the authors which had been evaluated from 1996 to 1999 by selecting discharge summaries from each institution containing at least one malignant tumour ICD code. Thus, we were able to compile an anonymous 16,000 patient register. 5 tumour locations were found in almost half the patients: breast (16.7 %), bowel (9.6 %), lung and bronchi (9.1 %), prostate gland (6.8 %), and skin (5.5 %). We estimate that the future ICL will take care of 2,500 cancer patients annually. We compared the number of new patients hospitalized each year (1,500) to the incidence reported by the manual cancer registers (FRANCIM). We conclude that this linking procedure is both feasible and acceptable when its precise health goal is clearly defined. Following this initial step, we are extending the procedure to involve other health care institutions (both public and private) in the Saint Etienne area and to the main regional cancer network (ONCORA). Beginning in 2001 the French ministry of health has approved this DRGs linking procedure throughout France.
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