Use of hospital discharge data for estimating morbidity in North Carolina

              ^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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