Accuracy of administrative data in trauma: splenic injuries as an example
| Autor: | Yi-Zarn Wang, Anthony A. Meyer, Glen Steeb, Curtis T. Hunter, Gregory S. Cherr, Mary Jo Wright, Kennan J. Buechter, John P. Hunt, Christopher C. Baker |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Quality Assurance Health Care Poison control Documentation Critical Care and Intensive Care Medicine Wounds Nonpenetrating Management Information Systems Diagnostic peritoneal lavage Trauma Centers Injury prevention medicine North Carolina Humans Registries Retrospective Studies medicine.diagnostic_test business.industry Medical record Data Collection medicine.disease Surgery Emergency medicine Orthopedic surgery Injury Severity Score Female Splenic disease business Orthopedic Procedures Spleen |
| Zdroj: | The Journal of trauma. 49(4) |
| ISSN: | 0022-5282 |
| Popis: | Background: Accurate data are needed to evaluate clinical outcomes, therapeutic modalities, and quality of care in trauma. Administrative data, usually used for billing, have been used to evaluate performance and assess therapy in other medical specialties. This study was performed to determine whether administrative databases are accurate in the recording of information about trauma patients with splenic injuries. Methods: Patients who had blunt splenic injuries were identified using a state trauma registry. The medical records of those patients were reviewed. The data collected by chart review were compared with data in the statewide administrative database of patients who had splenic injuries at the same four Level I and II trauma centers in the same 5-year period. Age, sex, admission date, and hospital were matched to assure comparison of the identical cohort. X 2 analysis was used to compare dichotomous data and Student's t test continuous data. Results: The administrative database identified 641 and the trauma registry identified 529 patients with a diagnosis of splenic injury. A total of 401 patients were found in both databases. Of these, 120 (22.7%) patients were not recorded in the administrative database. Injury Severity Score was underreported by the administrative database (25.74 ± 14.7 vs. 19.52 ± 11, p < 0.0001). The administrative database underreported orthopedic, chest, and head injuries (317 vs. 215, 325 vs. 228, and 234 vs. 155, respectively; all p < 0.0001). Use of abdominal computed tomographic scan and diagnostic peritoneal lavage were also underreported (260 vs. 56 and 104 vs. 17, both p < 0.0001). The number of operations on the spleen and number of orthopedic procedures were underreported (259 vs. 225, p < 0.014 and 147 vs. 94, p < 0.0001). Complications were markedly underreported by the administrative database (200 vs. 47, p < 0.0001) Conclusion: This study shows that administrative data lack accuracy in the recording of associated injuries, injury severity, diagnostics, procedures, and outcomes data in patients with splenic injuries. Whether these data should be used to evaluate treatment modalities or quality of care in trauma is questionable. |
| Databáze: | OpenAIRE |
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