The Danish helicopter emergency medical service database:high quality data with great potential
The Danish helicopter emergency medical service database:high quality data with great potential
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DOI：
10.1186/s13049-019-0615-5
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发表时间：
2019-04-05
影响因子：
3.3
通讯作者：
Moller, Thea Palsgaard
中科院分区：
文献类型：
--
作者：
Alstrup, Karen;Petersen, Jens Aage Kolsen;Moller, Thea Palsgaard
背景丹麦直升机紧急医疗服务 (HEMS) 是丹麦院前响应的一部分，在现场和快速转运至明确护理的过程中提供先进的患者护理。监测 HEMS 的表现和重症护理的质量具有高度的国家和国际优先事项，强调了该领域研究的必要性。丹麦 HEMS 数据库的数据质量未知。此外，最近提出了由国际合作组织（EQUIPE）开发的一套质量指标（QI），可能用于配备医生的 EMS。当前研究的目的是展示丹麦直升机数据库的设计和数据质量，并根据提出的 QI 评估数据库中可用变量的覆盖范围。方法该研究包括 2014 年 10 月 1 日至 2018 年 4 月 30 日期间的所有直升机调度。数据库布局和数据输入程序，以及描述了关键变量和数据完整性。此外，还解决了数据缺失和错误分类的问题。最后，评估了 EQUIPE 合作提出的 26 个 QI 在 HEMS 数据库中的覆盖范围。结果 研究中总共纳入了 13,392 个任务。该数据库包括与全国覆盖范围内的急病或受伤患者的院前路径相关的广泛的任务和患者特定数据。大多数变量的缺失数据小于 6.5%。随着时间的推移，完成的报告表格的百分比不断增加，在 2018 年达到 99.9%。在研究期间，观察到 294 名患者出现错误分类，相当于 3.7%。EQUIPE 合作小组提出的 QI 中只有不到一半可以直接从数据库中获得。结论丹麦的直升机紧急医疗服务是一个新的且调查较少的医疗保健提供者。该数据库包含了五个地区紧急医疗调度中心派出的几乎所有任务。一般来说，数据质量被认为很高，未来研究潜力巨大。EQUIPE协作组提出的潜在质量指标可以启发下一版本Hemsfile的配置和设计，为研究和质量改进奠定更坚实的基础。
BackgroundThe Danish Helicopter Emergency Medical Service (HEMS) is part of the Danish pre-hospital response offering advanced patient care on scene and during rapid transport to definitive care.Monitoring HEMS performance and the quality of critical care has high national as well as international priority underlining the need for research in this field.The data quality of the Danish HEMS database is unknown. Furthermore, a set of quality indicators (QI) developed by an international collaboration group (EQUIPE) potentially for use in physician-staffed EMS, has recently been presented.The aim of the current study was to present the design and data quality of the Danish helicopter database, and to evaluate the coverage of available variables in the database according to the QIs proposed.MethodThe study included all helicopter dispatches between October 1st 2014 and April 30th 2018.The database layout and data entering procedure, as well as the key variables and data completeness were described. Furthermore, missing data and misclassifications were addressed.Lastly, the 26 QIs proposed by the EQUIPE-collaboration were evaluated for coverage in the HEMS database.ResultsA total of 13,392 missions were included in the study. The database includes a broad spectrum of mission- and patient-specific data related to the pre-hospital pathway of acutely ill or injured patients in a national coverage. Missing data for the majority of variables is less than 6.5%. The percentage of completed report forms has increased over time and reached 99.9% in 2018.Misclassification were observed for 294 patients in the study period corresponding to 3,7%.Less than half of the QIs proposed by the EQUIPE-collaboration group were directly available from the database.ConclusionsHelicopter Emergency Medical Services in Denmark are a new and sparsely investigated health care provider. The database contains nearly all missions dispatched by the five regional Emergency Medical Dispatch Centres. Generally, the data quality is considered high with great potential for future research.Potential quality indicators as proposed by the EQUIPE-collaboration group could inspire the configuration and design of the next version of Hemsfile creating an even more solid basis for research and quality improvement.