Reliability of Information Abstracted from Diabetic Patients' Medical Records in Palestine

Background: Questionnaire based surveys are an importance tool in epidemiology and public health research. Although there may be a certain degree of bias in this quality of care assessment tool since some of these measurements may be misleading, it remains an inexpensive tool for such assessments. The quality of services provided to diabetic patients in Palestine has not been studied previously. This study provides a context for the measurement of the quality of care of patients with diabetes. Objectives: To evaluate the agreement on testing at the proper time between self-report and medical record in primary care centers in the West Bank. Methods: Data from interviews and medical records were available on 882 diabetic patients attending nine primary health care centers in Palestine. Cohen's kappa coefficient (k), agreement beyond chance, between data provided in patient medical record and self-report was calculated. Results: Agreement on testing at the proper time between self-report and medical record was poor to fair in strength (k: 0.06- 0.28), and was poor to substantial (k: 0.10- 0.70) for diabetes comorbids. After adjustment, clinic location and ownership were strong determinants for agreement in the proper time of testing. Also, the personal characteristic age and gender were the most important factors in determining comorbids in those patients. Conclusion: The evaluation of the quality of care based on medical records should be treated with great caution in Palestine since it’s a manual process. However, reliance on both sources of information is useful to establish monitoring tools on which decisions can be based.Acknowledgment We would like to thank all the patients who participated in the study. We also thank the study team, Mrs. Ibtisam Titi and Mrs. Adan Awaratni from the Ministry of Health and Mrs. Maha Nahal from the Faculty of Health professions of Al Quds University for their professional management of the field work. We would like to thank Mrs. Karen Mann for the English editing of this articles. Funding This work was supported by a grant from the Insulin Dependent Diabetes Trust (IDDT), Northampton, United Kingdom