Abstract
BackgroundIn Scotland all non-obstetric, non-psychiatric acute inpatient and day case stays are recorded by an administrative hospital discharge database, the Scottish Morbidity Record (SMR01). The Scottish Stroke Care Audit (SSCA) collects data from all hospitals managing acute stroke in Scotland to support and improve quality of stroke care. The aim was to assess whether there were discrepancies between these data sources for admissions from 2010 to 2011.MethodsRecords were matched when admission dates from the two data sources were within two days of each other and if an International Classification of Diseases (ICD) code of I61, I63, I64, or G45 was in the primary or secondary diagnosis field on SMR01. We also carried out a linkage analysis followed by a case-note review within one hospital in Scotland.ResultsThere were a total of 22 416 entries on SSCA and 22 200 entries on SMR01. The concordance between SSCA and SMR01 was 16 823. SSCA contained 5593 strokes that were not present in SMR01, whereas SMR01 contained 185 strokes that were not present in SSCA. In the case-note review the concordance was 531, with SSCA containing 157 strokes that were not present in SMR01 and SMR01 containing 32 strokes that were not present in SSCA.ConclusionsWhen identifying strokes, hospital administrative discharge databases should be used with caution. Our results demonstrate that SSCA most accurately represents the number of strokes occurring in Scotland. This resource is useful for determining the provision of adequate patient care, stroke services and resources, and as a tool for research.
Highlights
In Scotland all non-obstetric, non-psychiatric acute inpatient and day case stays are recorded by an administrative hospital discharge database, the Scottish Morbidity Record (SMR01)
Scotland-wide analysis There were a total of 22 416 entries on Scottish Stroke Care Audit (SSCA), and 22 200 entries on Scottish Morbidity Records 01 (SMR01) which contained a relevant International Classification of Diseases (ICD) code in either the primary or secondary diagnosis fields
12,552 records were found in both SSCA and SMR01 when matching on both date of admission and a main diagnosis code of I61, I63, and I64
Summary
In Scotland all non-obstetric, non-psychiatric acute inpatient and day case stays are recorded by an administrative hospital discharge database, the Scottish Morbidity Record (SMR01). Administrative hospital discharge coding data are currently collected by most Western countries in some form. These are seen as a useful tool for stroke research as they are anonymous, inexpensive, retrievable and available in an electronic format. Despite their advantages, there are limitations; assigning of diagnosis codes from limited information, data acquisition is retrospective, and no information on patient care is provided. The reliability of the recorded diagnoses has been questioned and the accuracy between administrative coding
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