期刊名称：International Journal of Population Data Science
电子版ISSN：2399-4908
出版年度：2017
卷号：1
期号：1
页码：1-1
DOI：10.23889/ijpds.v1i1.91
出版社：Swansea University
摘要：rural);iii/iv. Temporal order of diagnosis: diagnosis based on first or last record in transfer/EOC. ResultsThe proportion of cases that were transferred varied according to disease severity and time: 13% (1990) to 27% (2010) for STEMI; 5% to 7% for stable angina and unchanged at 4% for chest pain. Compared to transfer-level data using the first approach, unlinked data overestimated STEMI counts by 3% (1990) to 11% (2010), stable angina by 3% to 5% and chest pain by 6% to 6%. Similarly for EOC-level data, the overestimates were 5% (1990) to 12% (2010) for STEMI, 13% to 19% for stable angina and 20% to 14% for chest pain. The four approaches for allocating a diagnosis produced differing counts with the difference being larger for more clinically severe diagnoses than for less clinically severe diagnoses. For example, using transfer-level data, the differences between approaches i and iv in 2010 were 12%, 2% and 1% for STEMI, stable angina and chest pain respectively. ConclusionThere is a potential to overestimate counts of CHD in inpatient data if transfers and readmissions are not taken into account, and this inaccuracy can differ across disease subcategories and approach used. This has important implications where higher disease severity, such as myocardial infarction, is an indicator of population health. Transfer- or EOC-level data are more likely to reflect true CHD hospitalisation counts than unlinked-level data, and are more appropriate for epidemiological studies of CHD rates.
