Use of Hospital Discharge Data to Evaluate Notifiable Disease Reporting to Colorado's Electronic Disease Reporting System

Objective. Notifiable disease surveillance systems are critical for communicable disease control, and accurate and timely reporting of hospitalized patients who represent the most severe cases is important. A local health department in metropolitan Denver used inpatient hospital discharge (IHD) data...

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Published in:	Public health reports (1974) Vol. 126; no. 1; pp. 100 - 106
Main Authors:	Boehmer, Tegan K., Patnaik, Jennifer L., Burnite, Steven J., Ghosh, Tista S., Gershman, Ken, Vogt, Richard L.
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA Association of Schools of Public Health 01-01-2011 SAGE Publications SAGE PUBLICATIONS, INC
Subjects:	Colorado - epidemiology Discharge Disease control Disease Notification - methods Electronic health records Electronic Health Records - organization & administration Epidemiology Haemophilus Infections - epidemiology Haemophilus influenzae Hepatitis A Hepatitis A - epidemiology Hepatitis A virus Hospitals, Urban - statistics & numerical data Humans Infectious diseases International Classification of Diseases Legionellosis - epidemiology Legionnaires disease Medical Audit - methods Medical records Neisseria meningitidis Notifiable diseases Patient admissions Patient Discharge - statistics & numerical data Population Surveillance - methods Program Evaluation Public health Residence Characteristics - statistics & numerical data Salmonidae Sensitivity and Specificity Surveillance Temporal currency Time Factors West Nile Fever - epidemiology West Nile virus Whooping Cough - epidemiology ZIP codes Colorado Denver Colorado USA, Colorado, Denver USA, Colorado
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Summary:	Objective. Notifiable disease surveillance systems are critical for communicable disease control, and accurate and timely reporting of hospitalized patients who represent the most severe cases is important. A local health department in metropolitan Denver used inpatient hospital discharge (IHD) data to evaluate the sensitivity, timeliness, and data quality of reporting eight notifiable diseases to the Colorado Electronic Disease Reporting System (CEDRS). Methods. Using IHD data, we detected hospitalized patients admitted from 2003 through 2005 with a discharge diagnosis associated with one of eight notifiable diseases. Initially, we compared all cases identified through IHD diagnoses fields with cases reported to CEDRS. Second, we chose four diseases and conducted medical record review to confirm the IHD diagnoses before comparison with CEDRS cases. Results. Relying on IHD diagnoses only, shigellosis, salmonellosis, and Neisseria meningitidis invasive disease had high sensitivity (≥90%) and timeliness (≥75%); legionellosis, pertussis, and West Nile virus infection were intermediate; and hepatitis A and Haemophilus influenzae (H. influenzae) invasive disease had low sensitivity (≤25%) and timeliness (≤33%). Medical record review improved the sensitivity to ≥90% and timeliness to ≥80% for H. influenza invasive disease, legionellosis, and pertussis; however, hepatitis A retained suboptimal sensitivity (67%) and timeliness (25%). Conclusions. Hospital discharge data are useful for evaluating notifiable disease surveillance systems. Limitations encountered by using discharge diagnoses alone can be overcome by conducting medical record review. Public health agencies should conduct periodic surveillance system evaluations among hospitalized patients and reinforce notifiable disease reporting among the people responsible for this activity.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-1 ObjectType-Feature-3 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0033-3549 1468-2877
DOI:	10.1177/003335491112600114