[Update in medical informatics in oncology]

Abstract

Through the implementation of the French reform of resources allocation, according to the French DRG system (PMSI), all the medical records of French hospitals are currently indexed according to the same rules and classifications. As a by-product, these discharge summaries are merged into huge administrative databases covering both public and private settings. Statistical analysis of these data have begun, and seems to be worthwhile in oncology, e.g. for assessing the burden of cancer treatments in hospitals, for revealing the regional variations in practice or for estimating the incidence of melanoma. However, fully anonymous data leading to double counts, questionable quality of summaries and lack of complete covering in radiotherapy centres, still impede from using the data for epidemiological purpose. Short term improvements are under way: changes in quality assessment and control, possibility of linking successive stays of a patient while respecting privacy, implementation of new classification of procedures and new descriptions of "casemix". The French DRG could then have a place in the monitoring of cancer both at national and regional levels.