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The quality of denominator data in surgical site infection surveillance versus administrative data in Norway 2005-2010.

Løwer HL, Eriksen HM, Aavitsland P, Skjeldestad FE - BMC Infect. Dis. (2015)

Bottom Line: This study investigates the quality of NOIS-SSI's denominator data by evaluating completeness, representativeness and accuracy compared with de-identified administrative data for 2005-2010.The completeness of NOIS improved from 29.2 % in 2005 to 79.8 % in 2010.For the purpose of evaluating risk factors and implementing prevention and precautionary measures in the individual hospitals, representativeness seems sufficient, but for benchmarking and/or public reporting it is not good enough.

View Article: PubMed Central - PubMed

Affiliation: Norwegian Institute of Public Health, Department of Infectious Disease Epidemiology, Oslo, Norway. hege.line.lower@fhi.no.

ABSTRACT

Background: High quality of surveillance systems for surgical site infections (SSIs) is the key to their usefulness. The Norwegian Surveillance System for Antibiotic Consumption and Healthcare-Associated Infections (NOIS) was introduced by regulation in 2005, and is based largely on automated extraction of data from underlying systems in the hospitals.

Methods: This study investigates the quality of NOIS-SSI's denominator data by evaluating completeness, representativeness and accuracy compared with de-identified administrative data for 2005-2010. Comparisons were made by region, hospital type and size, age and sex for 4 surgical procedures.

Results: The completeness of NOIS improved from 29.2 % in 2005 to 79.8 % in 2010. NOIS-SSI became representative over time for most procedures by hospital size and type, but not by region. It was representative by age and sex for all years and procedures. Accuracy was good for all years and procedures by all explanatory variables.

Conclusions: A flexible and incremental implementation strategy has encouraged the development of computer-based surveillance systems in the hospitals which gives good accuracy, but the same strategy has adversely affected the completeness and representativeness of the denominator data. For the purpose of evaluating risk factors and implementing prevention and precautionary measures in the individual hospitals, representativeness seems sufficient, but for benchmarking and/or public reporting it is not good enough.

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Related in: MedlinePlus

Representativeness: proportion of procedures (in %) by hospital size in NOIS and NPR (2005–2010)
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Fig1: Representativeness: proportion of procedures (in %) by hospital size in NOIS and NPR (2005–2010)

Mentions: Figure 1 shows the representativeness of NOIS-SSI by comparing the distribution of the procedures in NOIS-SSI with NPR by hospital size for each year. During the first years of operation NOIS-SSI differed significantly from NPR. As more hospitals submitted data during the subsequent years the distributions became more similar and thus more representative for most procedures. There was similar pattern by hospital type (data not shown), and the differences between registers cease to be significant for CABG from 2008 and for CSEC from 2009. For HPRO, only 2009 had no significant differences between the registers. For CHOL the differences are significant for all years by hospital type. By region (data not shown) the differences in distribution between NOIS-SSI and NPR were greater. Only CABG in 2008 and 2009 and CSEC in 2010 had no significant differences. There were no significant differences in distribution by age and sex between NOIS-SSI and NPR (p > 0.05). The median age was about 66 for CABG, 31 for CSEC, 73 for HPRO and 49 for CHOL.Fig. 1


The quality of denominator data in surgical site infection surveillance versus administrative data in Norway 2005-2010.

Løwer HL, Eriksen HM, Aavitsland P, Skjeldestad FE - BMC Infect. Dis. (2015)

Representativeness: proportion of procedures (in %) by hospital size in NOIS and NPR (2005–2010)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4666046&req=5

Fig1: Representativeness: proportion of procedures (in %) by hospital size in NOIS and NPR (2005–2010)
Mentions: Figure 1 shows the representativeness of NOIS-SSI by comparing the distribution of the procedures in NOIS-SSI with NPR by hospital size for each year. During the first years of operation NOIS-SSI differed significantly from NPR. As more hospitals submitted data during the subsequent years the distributions became more similar and thus more representative for most procedures. There was similar pattern by hospital type (data not shown), and the differences between registers cease to be significant for CABG from 2008 and for CSEC from 2009. For HPRO, only 2009 had no significant differences between the registers. For CHOL the differences are significant for all years by hospital type. By region (data not shown) the differences in distribution between NOIS-SSI and NPR were greater. Only CABG in 2008 and 2009 and CSEC in 2010 had no significant differences. There were no significant differences in distribution by age and sex between NOIS-SSI and NPR (p > 0.05). The median age was about 66 for CABG, 31 for CSEC, 73 for HPRO and 49 for CHOL.Fig. 1

Bottom Line: This study investigates the quality of NOIS-SSI's denominator data by evaluating completeness, representativeness and accuracy compared with de-identified administrative data for 2005-2010.The completeness of NOIS improved from 29.2 % in 2005 to 79.8 % in 2010.For the purpose of evaluating risk factors and implementing prevention and precautionary measures in the individual hospitals, representativeness seems sufficient, but for benchmarking and/or public reporting it is not good enough.

View Article: PubMed Central - PubMed

Affiliation: Norwegian Institute of Public Health, Department of Infectious Disease Epidemiology, Oslo, Norway. hege.line.lower@fhi.no.

ABSTRACT

Background: High quality of surveillance systems for surgical site infections (SSIs) is the key to their usefulness. The Norwegian Surveillance System for Antibiotic Consumption and Healthcare-Associated Infections (NOIS) was introduced by regulation in 2005, and is based largely on automated extraction of data from underlying systems in the hospitals.

Methods: This study investigates the quality of NOIS-SSI's denominator data by evaluating completeness, representativeness and accuracy compared with de-identified administrative data for 2005-2010. Comparisons were made by region, hospital type and size, age and sex for 4 surgical procedures.

Results: The completeness of NOIS improved from 29.2 % in 2005 to 79.8 % in 2010. NOIS-SSI became representative over time for most procedures by hospital size and type, but not by region. It was representative by age and sex for all years and procedures. Accuracy was good for all years and procedures by all explanatory variables.

Conclusions: A flexible and incremental implementation strategy has encouraged the development of computer-based surveillance systems in the hospitals which gives good accuracy, but the same strategy has adversely affected the completeness and representativeness of the denominator data. For the purpose of evaluating risk factors and implementing prevention and precautionary measures in the individual hospitals, representativeness seems sufficient, but for benchmarking and/or public reporting it is not good enough.

Show MeSH
Related in: MedlinePlus