How accurate is the data provided to the Irish hip fracture database?

Area of Science:

• Orthopedics
• Health Informatics
• Data Integrity

Background:

• National health databases, like the Irish Hip Fracture Database (IHFD), are crucial for service coordination, funding, and research.
• Inaccuracies within these databases can lead to flawed policy and budget planning based on misrepresentative data.

Purpose of the Study:

• To audit the accuracy of the 2016 Irish Hip Fracture Database (IHFD) data collected within a specific trauma unit.
• To identify specific areas of inaccuracy in fracture classification and surgical procedure recording within the IHFD.

Main Methods:

• Comparison of IHFD-recorded data against author-derived classifications and procedures for 252 hip fracture cases.
• Analysis of Hospital In-Patient Enquiry (HIPE) data alongside IHFD and local logbook records.
• Assessment of data accuracy for fracture classification and operation performed.

Main Results:

• The IHFD-recorded fracture classification accuracy was 61%, significantly better than the HIPE-recorded accuracy of 29% (p < 0.001).
• The IHFD-recorded operation performed was accurate in 76% of cases.
• Eight cases (3%) were omitted from the local IHFD, compared to 36 cases (14%) omitted by HIPE (p < 0.001).
• Errors stemmed from poor documentation regarding fracture displacement, prosthesis coating, and nail length.

Conclusions:

• Improving documentation clarity and providing education on coding for junior surgical trainees can significantly enhance data accuracy.
• Dedicated data coordination efforts within the unit doubled data accuracy and reduced omitted cases by 4.5 times.
• Ensuring the integrity of the IHFD is vital to prevent negative impacts on hospital reimbursement and national health policy.