Data consistency in the English Hospital Episodes Statistics database

Autor: Adrian Hopper, William K Gray, Jamie Day, Tim W R Briggs, Flavien Hardy, Johannes Heyl, Katie Tucker, Maria J Marchã, Jeremy Yates, Andrew Wheeler, Sue Eve-Jones
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMJ Health & Care Informatics, Vol 29, Iss 1 (2022)
Druh dokumentu: article
ISSN: 2632-1009
DOI: 10.1136/bmjhci-2022-100633
Popis: Background To gain maximum insight from large administrative healthcare datasets it is important to understand their data quality. Although a gold standard against which to assess criterion validity rarely exists for such datasets, internal consistency can be evaluated. We aimed to identify inconsistencies in the recording of mandatory International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10) codes within the Hospital Episodes Statistics dataset in England.Methods Three exemplar medical conditions where recording is mandatory once diagnosed were chosen: autism, type II diabetes mellitus and Parkinson’s disease dementia. We identified the first occurrence of the condition ICD-10 code for a patient during the period April 2013 to March 2021 and in subsequent hospital spells. We designed and trained random forest classifiers to identify variables strongly associated with recording inconsistencies.Results For autism, diabetes and Parkinson’s disease dementia respectively, 43.7%, 8.6% and 31.2% of subsequent spells had inconsistencies. Coding inconsistencies were highly correlated with non-coding of an underlying condition, a change in hospital trust and greater time between the spell with the first coded diagnosis and the subsequent spell. For patients with diabetes or Parkinson’s disease dementia, the code recording for spells without an overnight stay were found to have a higher rate of inconsistencies.Conclusions Data inconsistencies are relatively common for the three conditions considered. Where these mandatory diagnoses are not recorded in administrative datasets, and where clinical decisions are made based on such data, there is potential for this to impact patient care.
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