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General Orthopaedics

IS IT TIME FOR SURGEONS TO START COLLECTING THEIR OWN DATA?

British Orthopaedic Association (BOA) 2005



Abstract

Hospital Episode Statistics [HES] are often used by hospital managers and politicians as a reflection of departmental workload. The accuracy of these data is often questioned. We aimed to ascertain the reliability of this database for trauma admissions.

Between 2002 and 2003, all admissions were recorded by doctors using a separate departmental database. Data were collected during the daily trauma meetings and compared with the HES returns for the same period. 2496 patients were recorded in the trauma admissions database. Overall, 36.4% of the patients were either not recorded by the HES database or wrongly coded in terms of type of admissions or diagnosis.

HES data for all 2496 records was analysed by type of admissions and speciality.4.2% of trauma patients were incorrectly classified as elective or day cases. 2.9% of trauma patients admitted to hospital were not recorded in the HES data as orthopaedic admission.

The accuracy of HES diagnosis coding was tested on 300 records randomly selected by a statistical package. HES recorded the wrong diagnosis in 29.3% of cases. A significant number of trauma cases were not counted in the HES data. This may have significant implications for trauma funding.

HES data does not accurately record diagnosis and therefore can not be used as a research tool for specific injuries. Data recording practice should be changed to improve HES data accuracy.