Hakenewerth Anne M, Waller Anna E, Ising Amy I, Tintinalli Judith E
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Acad Emerg Med. 2009 Mar;16(3):261-9. doi: 10.1111/j.1553-2712.2008.00334.x. Epub 2008 Dec 30.
The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) is a near-real-time database of emergency department (ED) visits automatically extracted from hospital information system(s) in the state of North Carolina. The National Hospital Ambulatory Medical Care Survey (NHAMCS) is a retrospective probability sample survey of visits to U.S. hospital EDs. This report compares data from NC DETECT (2006) with NHAMCS (2005) ED visit data to determine if the two data sets are consistent. Proportions, rates, and confidence intervals (CIs) were calculated for ED visits by age and gender; arrival method and age; expected source of payment; disposition; hospital admissions; NHAMCS top 20 diagnosis groups and top five primary diagnoses by age group; International Classifications of Disease, 9th revision, Clinical Modification (ICD-9-CM) primary diagnosis codes; and cause of injury. North Carolina DETECT captured 79% of statewide ED visits. Twenty-eight persons for every 100 North Carolina residents visited a North Carolina ED that reports to NC DETECT at least once in 2006, compared to 20% nationally. Twenty-seven percent of ED visits in North Carolina had private insurance as the expected payment source, compared with 40% nationwide. The proportion of injury-related ED visits in North Carolina is 25%, compared to 36.4% nationally. Rates and proportions of disease groups are similar. Similarity of NC DETECT rates and proportions to NHAMCS provides support for the face and content validity of NC DETECT. The development of statewide near-real-time ED databases is an important step toward the collection, aggregation, and analysis of timely, population-based data by state, to better define the burden of illness and injury for vulnerable populations.
北卡罗来纳州疾病事件跟踪与流行病学收集工具(NC DETECT)是一个近乎实时的数据库,它自动从北卡罗来纳州的医院信息系统中提取急诊室就诊数据。美国国家医院门诊医疗调查(NHAMCS)是一项针对美国医院急诊室就诊情况的回顾性概率抽样调查。本报告比较了NC DETECT(2006年)与NHAMCS(2005年)的急诊室就诊数据,以确定这两个数据集是否一致。按年龄和性别、到达方式和年龄、预期支付来源、处置方式、住院情况、NHAMCS前20个诊断组以及按年龄组划分的前五个主要诊断、国际疾病分类第九版临床修订本(ICD-9-CM)主要诊断代码和受伤原因计算了急诊室就诊的比例、率和置信区间(CI)。北卡罗来纳州DETECT收集了该州79%的急诊室就诊数据。2006年,每100名北卡罗来纳州居民中有28人至少去过一次向北卡罗来纳州DETECT报告的急诊室,而全国这一比例为20%。北卡罗来纳州急诊室就诊中有27%的预期支付来源是私人保险,而全国这一比例为40%。北卡罗来纳州与受伤相关的急诊室就诊比例为25%,而全国为36.4%。疾病组的率和比例相似。NC DETECT的率和比例与NHAMCS的相似性为NC DETECT的表面效度和内容效度提供了支持。建立全州范围的近乎实时急诊室数据库是朝着按州收集、汇总和分析及时的基于人群的数据迈出的重要一步,以便更好地确定弱势群体的疾病和受伤负担。