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^ORTH CAROLINA STATE LIBRARY STUDIES N. C Doc. 2 2 1981 A SPECIAL REPORT SERIES BY THE N.C. DEPARTMENT OF HUMAN RESOURCES, DIVISION OF HEALTH SERVICES, STATE CENTER FOR HEALTH STATISTICS, P.O. BOX 2091, RALEIGH, N.C. 27602 No. 20 July 198L THE USE OF HOSPITAL DISCHARGE DATA FOR ESTIMATING MORBIDITY IN NORTH CAROLINA In October of 1978, data were collected on North Carolina residents discharged from short-stay general hospitals. This project involved the cooperation of health planning agencies and the hospital association in North Carolina. As stated in a letter from the N.C. Hospital Association requesting the participation of hospitals, the purpose of the study was " to provide hospitals and health planning agencies some basic data needed for cooperative planning, and to test the feasibility and usefulness of a continuing hospital data base." Vne main purpose of this report is to present morbidity estimates derived from the October 1978 data, but first it will be useful to provide some background concerning how the study was carried out. Study Background There has been discussion for a number of years of the desirability of a hospital "data consortium" in North Carolina. Under this concept, hospitals throughout the state would submit data a single time to a data processor or "broker," which would then act as a clearinghouse for the various and often duplicative information requests received by the hospitals. While good in theory, this idea has proved difficult to implement because of political, financial, and other obstacles. The October 1978 study was designed to demonstrate the feasibility of using a single data submission for multiple purposes. Participating hospitals that completed October abstracting by a certain date were provided a summary report of information required for the geographic service area section of the annual hospital licensure form. In addition, all participating hospitals received patient origin reports oriented toward facility planning, including comparable utilization information for other institutions serving the same geographic area. The central idea was to promote cooperative planning among hospitals and with the health planning agencies, which received the same information. Over half of the participating hosoitals took advantage of the licensure report service in spite of the short data turnaround time required. Though this one-month pilot study has not directly led to a centralized hospital data base, it has demonstrated the feasibility of collecting discharge data on a large scale, and has sensitized hospitals and other parties to the advantages of pooling and sharing data. All but 12 of the 132 short-term general hospitals in the state participated in the October 1978 study. Emphasis was on collecting data through existing systems, and information for about 75 percent of N.C. hospital patients was obtained from discharge abstracts of the ongoing Professional Activity Study (PAS). Another 10 percent of the month's discharges were captured through the computer systems of five large hospitals in the state, with data on the other patients in the study manually coded and then keypunched. Most of the major out-of-state hospitals receiving N.C. patients agreed to code data for N.C. residents discharged in October, and overall about 94 percent of N.C. residents going to short-term general hospitals during the month were captured in the study (1). About 71,000 N.C. residents plus out-of-state residents discharged from N.C. hospitals yielded a total sample size of 73,307. For each patient the following •
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Full Text | ^ORTH CAROLINA STATE LIBRARY STUDIES N. C Doc. 2 2 1981 A SPECIAL REPORT SERIES BY THE N.C. DEPARTMENT OF HUMAN RESOURCES, DIVISION OF HEALTH SERVICES, STATE CENTER FOR HEALTH STATISTICS, P.O. BOX 2091, RALEIGH, N.C. 27602 No. 20 July 198L THE USE OF HOSPITAL DISCHARGE DATA FOR ESTIMATING MORBIDITY IN NORTH CAROLINA In October of 1978, data were collected on North Carolina residents discharged from short-stay general hospitals. This project involved the cooperation of health planning agencies and the hospital association in North Carolina. As stated in a letter from the N.C. Hospital Association requesting the participation of hospitals, the purpose of the study was " to provide hospitals and health planning agencies some basic data needed for cooperative planning, and to test the feasibility and usefulness of a continuing hospital data base." Vne main purpose of this report is to present morbidity estimates derived from the October 1978 data, but first it will be useful to provide some background concerning how the study was carried out. Study Background There has been discussion for a number of years of the desirability of a hospital "data consortium" in North Carolina. Under this concept, hospitals throughout the state would submit data a single time to a data processor or "broker," which would then act as a clearinghouse for the various and often duplicative information requests received by the hospitals. While good in theory, this idea has proved difficult to implement because of political, financial, and other obstacles. The October 1978 study was designed to demonstrate the feasibility of using a single data submission for multiple purposes. Participating hospitals that completed October abstracting by a certain date were provided a summary report of information required for the geographic service area section of the annual hospital licensure form. In addition, all participating hospitals received patient origin reports oriented toward facility planning, including comparable utilization information for other institutions serving the same geographic area. The central idea was to promote cooperative planning among hospitals and with the health planning agencies, which received the same information. Over half of the participating hosoitals took advantage of the licensure report service in spite of the short data turnaround time required. Though this one-month pilot study has not directly led to a centralized hospital data base, it has demonstrated the feasibility of collecting discharge data on a large scale, and has sensitized hospitals and other parties to the advantages of pooling and sharing data. All but 12 of the 132 short-term general hospitals in the state participated in the October 1978 study. Emphasis was on collecting data through existing systems, and information for about 75 percent of N.C. hospital patients was obtained from discharge abstracts of the ongoing Professional Activity Study (PAS). Another 10 percent of the month's discharges were captured through the computer systems of five large hospitals in the state, with data on the other patients in the study manually coded and then keypunched. Most of the major out-of-state hospitals receiving N.C. patients agreed to code data for N.C. residents discharged in October, and overall about 94 percent of N.C. residents going to short-term general hospitals during the month were captured in the study (1). About 71,000 N.C. residents plus out-of-state residents discharged from N.C. hospitals yielded a total sample size of 73,307. For each patient the following • |