Nakahara Shinji, Sakamoto Tetsuya, Fujita Takashi, Koyama Tomohide, Katayama Yoichi, Tanabe Seizan, Yamamoto Yasuhiro
Department of Emergency Medicine Teikyo University School of Medicine Tokyo Japan.
Department of Emergency Medicine Sapporo Medical University Sapporo Japan.
Acute Med Surg. 2017 Aug 7;4(4):432-438. doi: 10.1002/ams2.302. eCollection 2017 Oct.
Accurate evaluation of health care quality requires high-quality data, and case ascertainment (confirming eligible cases and deaths) is a foundation for accurate data collection. This study examined the accuracy of case ascertainment from two Japanese data sources.
Using hospital-level data, we investigated the concordance in ascertaining trauma cases between a nationwide trauma registry (the Japan Trauma Data Bank) and annual government evaluations of tertiary hospitals between April 2012 and March 2013. We compared the median values for trauma case volumes, numbers of deaths, and case fatality rates from both data sources, and also evaluated the variability in discrepancies for the intrahospital differences of these outcomes.
The analyses included 136 hospitals. In the registry and annual evaluation data, the median case volumes were 120.5 cases and 180.5 cases, respectively; the median numbers of deaths were 11 and 12, respectively; and the median case fatality rates were 8.1% and 6.4%, respectively. There was broad variability in the intrahospital differences in these outcomes.
The observed discordance between the two data sources implies that these data sources may have inaccuracies in case ascertainment. Measures are needed to evaluate and improve the accuracy of data from these sources.
准确评估医疗质量需要高质量的数据,而病例确定(确认符合条件的病例和死亡情况)是准确收集数据的基础。本研究检验了来自两个日本数据源的病例确定的准确性。
利用医院层面的数据,我们调查了2012年4月至2013年3月期间全国创伤登记处(日本创伤数据库)与政府对三级医院的年度评估在确定创伤病例方面的一致性。我们比较了两个数据源的创伤病例数量、死亡人数和病死率的中位数,还评估了这些结果在医院内部差异方面差异的变异性。
分析纳入了136家医院。在登记处数据和年度评估数据中,病例数量中位数分别为120.5例和180.5例;死亡人数中位数分别为11人和12人;病死率中位数分别为8.1%和6.4%。这些结果在医院内部差异方面存在很大变异性。
两个数据源之间观察到的不一致表明这些数据源在病例确定方面可能存在不准确之处。需要采取措施来评估和提高这些来源数据的准确性。