A regional perinatal database in southern Sweden--a basis for quality assurance in obstetrics and neonatology.

Background: In order to ensure as few avoidable adverse outcomes of pregnancy as possible, it is necessary to continuously evaluate the quality of both obstetric and neonatal care. The eleven southernmost hospitals in Sweden have joined together in a project of developing a regional database, with special emphasis on rapid output of information in order to identify changing trends.

Methods: A regional computerized database has been developed, collecting variables and quality indicators agreed upon by all participants. Specific protocols have been designed for obstetric care, neonatal care and autopsy findings. All participating units transfer information on paper forms or via local computerized information systems. The regional database thus receives data on about 20,000 deliveries annually.

Results: Data collection started on September 1, 1994. The first results are due in March 1996, and thereafter on a regular basis every 3 months. Special methods for rapid analysis of raw data have been developed with the help of commercially available data analysis tools.

Conclusions: It is possible to construct an information system with different computer platforms and different database tools at each participating facility, as long as the database systems are locally controllable. That a software is commercially available is no guarantee that data transfer to a central database is possible. Experience from participating sites also indicates that a specialized database is needed for registering obstetric data, as general computerized record-keeping systems are unable to cope with an event concerning more than one subject at a time.