scholarly journals Describing the burden of diphtheria in Canada from 2006 to 2017, using hospital administrative data and reportable disease data

2021 ◽  
Vol 47 (10) ◽  
pp. 414-421
Author(s):  
Dolly Lin ◽  
Brigitte Ho Mi Fane ◽  
Susan G Squires ◽  
Catherine Dickson
Keyword(s):  
Administrative Data ◽  
Age Groups ◽  
Notifiable Disease ◽  
Discharge Abstract Database ◽  
Discharge Data ◽  
Vaccination Programs ◽  
Disease Reduction ◽  
Low Incidence ◽  
Hospital Administrative ◽  
Hospital Administrative Data

Background: Canada has maintained a low incidence of toxigenic diphtheria since the 1990s, supported by continued commitment to publicly funded vaccination programs. Objective: To determine whether hospitalization data, complemented with notifiable disease data, can describe the toxigenic respiratory and cutaneous diphtheria burden in Canada, and to assess if Canada is meeting its diphtheria vaccine–preventable disease-reduction target of zero annual cases of locally transmitted respiratory diphtheria. Methods: Diphtheria-related hospital discharge data from 2006 to 2017 were extracted from the Discharge Abstract Database (DAD), and diphtheria case counts for the same period were retrieved from the Canadian Notifiable Disease Surveillance System (CNDSS), for descriptive analyses. As data from the province of Québec are not included in the DAD, CNDSS cases from Québec were excluded. Results: A total of 233 diphtheria-related hospitalizations were recorded in the DAD. Of these, diphtheria was the most responsible diagnosis in 23. Half the patients were male (52%), and 57% were 60 years and older. Central region (Ontario) accounted for the most discharge records (61%), followed by Prairie region (Alberta, Manitoba and Saskatchewan; 23%). Cutaneous diphtheria accounted for 43% of records, and respiratory diphtheria accounted for 3%, with the remainder being other diphtheria complications or site unspecified. Two records with diphtheria as the most responsible diagnosis resulted in inpatient deaths. Eighteen cases of diphtheria were reported through CNDSS. Cases occurred in all age groups, with the largest proportions among those aged 20 to 59 years (39%) and those aged 19 years and younger (33%). Cases were only reported in the Prairie (89%) and West Coast (British Columbia; 11%) regions. Conclusion: Hospital administrative data are consistent with the low incidence of diphtheria reported in CNDSS, and a low burden of respiratory diphtheria in Canada. Although Canada appears to be on track to meet its disease-reduction target, information on endemic transmission is not available.

scholarly journals Establishing a composite neonatal adverse outcome indicator using English hospital administrative data

2018 ◽  
Vol 104 (5) ◽  
pp. F502-F509 ◽  
Author(s):  
Hannah Ellin Knight ◽  
Sam J Oddie ◽  
Katie L Harron ◽  
Harriet K Aughey ◽  
Jan H van der Meulen ◽  
...  
Keyword(s):  
Data Quality ◽  
Predictive Validity ◽  
Administrative Data ◽  
Adverse Outcome ◽  
First Year ◽  
Risk Of Death ◽  
Outcome Indicator ◽  
Hospital Administrative ◽  
First Year Of Life ◽  
Hospital Administrative Data

ObjectiveWe adapted a composite neonatal adverse outcome indicator (NAOI), originally derived in Australia, and assessed its feasibility and validity as an outcome indicator in English administrative hospital data.DesignWe used Hospital Episode Statistics (HES) data containing information infants born in the English National Health Service (NHS) between 1 April 2014 and 31 March 2015. The Australian NAOI was mapped to diagnoses and procedure codes used within HES and modified to reflect data quality and neonatal health concerns in England. To investigate the concurrent validity of the English NAOI (E-NAOI), rates of NAOI components were compared with population-based studies. To investigate the predictive validity of the E-NAOI, rates of readmission and death in the first year of life were calculated for infants with and without E-NAOI components.ResultsThe analysis included 484 007 (81%) of the 600 963 eligible babies born during the timeframe. 114/148 NHS trusts passed data quality checks and were included in the analysis. The modified E-NAOI included 23 components (16 diagnoses and 7 procedures). Among liveborn infants, 5.4% had at least one E-NAOI component recorded before discharge. Among newborns discharged alive, the E-NAOI was associated with a significantly higher risk of death (0.81% vs 0.05%; p<0.001) and overnight hospital readmission (15.7% vs 7.1%; p<0.001) in the first year of life.ConclusionsA composite NAOI can be derived from English hospital administrative data. This E-NAOI demonstrates good concurrent and predictive validity in the first year of life. It is a cost-effective way to monitor neonatal outcomes.

scholarly journals How Reliable Are Administrative Data for Capturing Stroke Patients and Their Care

2016 ◽  
Vol 6 (3) ◽  
pp. 96-106 ◽  
Author(s):  
Joan Porter ◽  
Luke Mondor ◽  
Moira K. Kapral ◽  
Jiming Fang ◽  
Ruth E. Hall
Keyword(s):  
Ischemic Stroke ◽  
Administrative Data ◽  
Stroke Risk ◽  
Billing Data ◽  
Stroke Risk Factors ◽  
Physician Billing ◽  
Stroke Type ◽  
Hospital Administrative ◽  
Kappa Agreement ◽  
Hospital Administrative Data

Background/Aims: The reliability of diagnostic coding of acute stroke and transient ischemic attack (TIA) in administrative data is uncertain. The purpose of this study is to determine the agreement between administrative data sources and chart audit for the identification of stroke type, stroke risk factors, and the use of hospital-based diagnostic procedures in patients with stroke or TIA. Methods: Medical charts for a population-based sample of patients (n = 14,508) with ischemic stroke, intracerebral hemorrhage (ICH), or TIA discharged from inpatient and emergency departments (ED) in Ontario, Canada, between April 1, 2012 and March 31, 2013, were audited by trained abstractors. Audited data were linked and compared with hospital administrative data and physician billing data. The positive predictive value (PPV) of hospital administrative data and kappa agreement for the reporting of stroke type were calculated. Kappa agreement was also determined for stroke risk factors and for select stroke-related procedures. Results: The PPV for stroke type in inpatient administrative data ranged from 89.5% (95% CI 88.0-91.0) for TIA, 91.9% (95% CI 90.2-93.5) for ICH, and 97.3% (95% CI 96.9-97.7) for ischemic stroke. For ED administrative data, PPV varied from 78.8% (95% CI 76.3-81.2) for ischemic, 86.3% (95% CI 76.8-95.7) for ICH, and 95.3% (95% CI 94.6-96.0) for TIA. The chance-corrected agreement between the audited and administrative data was good for atrial fibrillation (k = 0.60) and very good for diabetes (k = 0.86). Hospital administrative data combined with physician billing data more than doubled the observed agreement for carotid imaging (k = 0.65) and echocardiography (k = 0.66) compared to hospital administrative data alone. Conclusions: Inpatient and ED administrative data were found to be reliable in the reporting of the International Classification of Diagnosis, 10th revision, Canada (ICD-10-CA)-coded ischemic stroke, ICH and TIA, and for the recording of atrial fibrillation and diabetes. The combination of physician billing data with hospital administrative data greatly improved the capture of some diagnostic services provided to inpatients.

Identifying Communication-Impaired Pediatric Patients Using Detailed Hospital Administrative Data

2016 ◽  
Vol 6 (8) ◽  
pp. 456-467
Author(s):  
D. L. Hill ◽  
K. W. Carroll ◽  
D. Dai ◽  
J. A. Faerber ◽  
S. L. Dougherty ◽  
...  
Keyword(s):  
Administrative Data ◽  
Pediatric Patients ◽  
Hospital Administrative ◽  
Hospital Administrative Data

Does parental report of insurance status agree with hospital administrative data for children presenting to the ED?

2006 ◽  
Vol 24 (7) ◽  
pp. 890-892
Author(s):  
Mark I. Neuman ◽  
Michael S. Radeos ◽  
Anthony Yang ◽  
James A. Gordon ◽  
Carlos A. Camargo
Keyword(s):  
Administrative Data ◽  
Insurance Status ◽  
Parental Report ◽  
Hospital Administrative ◽  
Hospital Administrative Data

scholarly journals Ten-year trends in stroke admissions and outcomes in Canada

2015 ◽  
Vol 42 (3) ◽  
pp. 168-175 ◽  
Author(s):  
Noreen Kamal ◽  
M. Patrice Lindsay ◽  
Robert Côté ◽  
Jiming Fang ◽  
Moira K. Kapral ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Hospital Admissions ◽  
Age Groups ◽  
Population Based ◽  
Stroke Patients ◽  
Discharge Abstract Database ◽  
Absolute Increase ◽  
Admission Rates ◽  
Administrative Dataset ◽  
Hospital Administrative

AbstractBackgroundWe analyzed a 10-year stroke administrative dataset to examine trends in admissions, mortality, and discharge destination in Canada.MethodsWe conducted an analysis of hospital administrative data from April 1st 2003 to March 31st 2013 from the Canadian Institute of Health Information’s Discharge Abstract Database. Ten-year trends for population-based age- and sex-standardized admission rates were calculated. We reviewed 10-year trends in absolute stroke admissions for differences between provinces and age groups. Stroke 30-day in-hospital mortality rates were calculated and adjusted for sex, age, stroke type and comorbidities. We documented changes in discharge location for ischemic and hemorrhagic stroke patients discharged from acute care.ResultsThe rate of hospital admissions has declined from 140.2 to 117.5 (per 100,000 people). The number of absolute stroke admissions within provinces increased in Alberta and British Columbia (21.7% and 16.2% respectively). The proportion of stroke patients aged 40-69 years old increased by 4.8% (p<0.0001) over the 10 years, whereas the proportion aged over 70 decreased by 4.9% (p<0.0001). Risk-adjusted 30-day in-hospital mortality decreased from: 18.5% to 14.9% for all strokes; 15.2% to 12.1% for ischemic strokes; 35.6% to 29.7% for intracerebral hemorrhage; and 25.1% to 18.0% for subarachnoid hemorrhage. The absolute increase in patients requiring inpatient and outpatient support increased by 4% (p<0.0001).ConclusionThe rate of admissions for stroke is decreasing but there is an increase in stroke admissions for younger patients. In-hospital mortality is decreasing; fewer patients are going directly home without services and more are requiring support services.

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