Muzerengi S, Rick C, Begaj I, Ives N, Evison F, Woolley R L, Clarke C E
College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK; University Hospital Birmingham Foundation Trust, Queen Elizabeth Hospital Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK.
College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Public Health. 2017 May;146:4-9. doi: 10.1016/j.puhe.2016.12.024. Epub 2017 Jan 28.
Hospital Episode Statistics data are used for healthcare planning and hospital reimbursements. Reliability of these data is dependent on the accuracy of individual hospitals reporting Secondary Uses Service (SUS) which includes hospitalisation. The number and coding accuracy for Parkinson's disease hospital admissions at a tertiary centre in Birmingham was assessed.
Retrospective, routine-data-based study.
A retrospective electronic database search for all Parkinson's disease patients admitted to the tertiary hospital over a 4-year period (2009-2013) was performed on the SUS database using International Classification of Disease codes, and on the local inpatient electronic prescription database, Prescription and Information Communications System, using medication prescriptions. Capture-recapture methods were used to estimate the number of patients and admissions missed by both databases.
From the two databases, between July 2009 and June 2013, 1068 patients with Parkinson's disease accounted for 1999 admissions. During these admissions, the Parkinson's disease was coded as a primary or secondary diagnosis. Ninety-one percent of these admissions were recorded on the SUS database. Capture-recapture methods estimated that the number of Parkinson's disease patients admitted during this period was 1127 patients (95% confidence interval: 1107-1146). A supplementary search of both SUS and Prescription and Information Communications System was undertaken using the hospital numbers of these 1068 patients. This identified another 479 admissions. SUS database under-estimated Parkinson's disease admissions by 27% during the study period.
The accuracy of disease coding is critical for healthcare policy planning and must be improved. If the under-reporting of Parkinson's disease admissions on the SUS database is repeated nationally, expenditure on Parkinson's disease admissions in England is under-estimated by approximately £61 million per year.
医院事件统计数据用于医疗保健规划和医院报销。这些数据的可靠性取决于各医院报告二级用途服务（SUS，包括住院情况）的准确性。对伯明翰一家三级中心帕金森病住院患者的数量及编码准确性进行了评估。
基于常规数据的回顾性研究。
在SUS数据库中使用国际疾病分类编码，对一家三级医院在4年期间（2009 - 2013年）收治的所有帕金森病患者进行回顾性电子数据库检索；同时在本地住院电子处方数据库“处方与信息通信系统”中，利用药物处方进行检索。采用捕获 - 再捕获方法估算两个数据库遗漏的患者数量和住院次数。
从这两个数据库中可知，在2009年7月至2013年6月期间，1068名帕金森病患者有1999次住院记录。在这些住院记录中，帕金森病被编码为主要或次要诊断。其中91%的住院记录登记在SUS数据库中。捕获 - 再捕获方法估计，在此期间收治的帕金森病患者数量为1127例（95%置信区间：1107 - 1146）。利用这1068名患者的医院编号，对SUS数据库和“处方与信息通信系统”进行了补充检索，又识别出479次住院记录。研究期间，SUS数据库将帕金森病住院记录少报了27%。
疾病编码的准确性对于医疗保健政策规划至关重要，必须加以改进。如果SUS数据库对帕金森病住院记录少报的情况在全国范围内普遍存在，那么英格兰每年帕金森病住院费用估计少报约6100万英镑。
