Evaluating maternity care using national administrative health datasets: how are statistics affected by the quality of data on method of delivery?
Evaluating maternity care using national administrative health datasets: how are statistics affected by the quality of data on method of delivery?
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DOI：
10.1186/1472-6963-13-200
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发表时间：
2013-05-30
影响因子：
2.8
通讯作者：
Cromwell DA
中科院分区：
文献类型：
--
作者：
Knight HE;Gurol-Urganci I;Mahmood TA;Templeton A;Richmond D;van der Meulen JH;Cromwell DA
关于孕产服务的信息越来越多地来自国家行政卫生数据。我们评估了国家数据集中“分娩方法”数据的完整性和一致性如何影响英格兰孕产妇护理统计数据。 2009 年 4 月至 2010 年 3 月期间英国 NHS 信托机构中发生的单胎分娩是从医院发作统计 (HES) 数据库中提取的。在 HES 中，分娩方式可以输入两次：1) 作为核心字段中的程序代码，2) 在补充产科字段中。我们检查了这些数据源在国家层面和个人信托之间的整体一致性。然后使用三个产妇统计数据检查不同分析规则处理不一致数据的影响：紧急剖腹产（CS）率；器械助产中的三度/四度撕裂率，以及臀位的选择性 CS 率。我们确定了 629,049 个单件交付。分别有 0.8% 和 12.5% 的记录未将交付方式作为程序或补充字段输入。在包含这两个数据项的 545,594 条记录中，交付方法的编码一致为 96.3%（kappa = 0.93；p < 0.001）。 136 个 NHS 信托机构中有 11 个的一致性相对较差 (<92%)，表明存在系统性数据输入错误。不同的分析规则对国家层面的统计数据影响很小，但对各个 NHS 信托机构的影响可能很大。臀位的选择性 CS 率对所选分析规则最敏感。组织生育统计数据对分娩方法数据的不一致很敏感，质量指标的出版物应描述如何处理这些数据。总体而言，交付方法在英语管理健康数据中的编码是一致的。
Information on maternity services is increasingly derived from national administrative health data. We evaluated how statistics on maternity care in England were affected by the completeness and consistency of data on “method of delivery” in a national dataset. Singleton deliveries occurring between April 2009 and March 2010 in English NHS trusts were extracted from the Hospital Episode Statistics (HES) database. In HES, method of delivery can be entered twice: 1) as a procedure code in core fields, and 2) in supplementary maternity fields. We examined overall consistency of these data sources at a national level and among individual trusts. The impact of different analysis rules for handling inconsistent data was then examined using three maternity statistics: emergency caesarean section (CS) rate; third/fourth degree tear rate amongst instrumental deliveries, and elective CS rate for breech presentation. We identified 629,049 singleton deliveries. Method of delivery was not entered as a procedure or in the supplementary fields in 0.8% and 12.5% of records, respectively. In 545,594 records containing both data items, method of delivery was coded consistently in 96.3% (kappa = 0.93; p < 0.001). Eleven of 136 NHS trusts had comparatively poor consistency (<92%) suggesting systematic data entry errors. The different analysis rules had a small effect on the statistics at a national level but the effect could be substantial for individual NHS trusts. The elective CS rate for breech was most sensitive to the chosen analysis rule. Organisational maternity statistics are sensitive to inconsistencies in data on method of delivery, and publications of quality indicators should describe how such data were handled. Overall, method of delivery is coded consistently in English administrative health data.
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DOI：
10.1136/bmj.c5065
发表时间：
2010-10-06
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Bragg F;Cromwell DA;Edozien LC;Gurol-Urganci I;Mahmood TA;Templeton A;van der Meulen JH
通讯作者：
van der Meulen JH
影响因子：
9.6
作者：
Johal, A.;Mitchell, D.;van der Meulen, J.
通讯作者：
van der Meulen, J.
影响因子：
9.8
作者：
Yasmeen, S;Romano, PS;Gilbert, WM
通讯作者：
Gilbert, WM
影响因子：
2.3
作者：
Kuklina, Elena V.;Whiteman, Maura K.;Marchbanks, Polly A.
通讯作者：
Marchbanks, Polly A.
DOI：
10.1111/j.1479-828x.2008.00910.x
发表时间：
2008-10-01
影响因子：
1.7
作者：
Lain, Samantha J.;Roberts, Christine L.;Morris, Jonathan M.
通讯作者：
Morris, Jonathan M.