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Accuracy of centrally recorded OPCS codes for vascular surgery in the United Kingdom
R B Galland1, T R Magee, D C Berridge
1Royal Berkshire Hospital, Reading, U.K.
Insights
Central recording of vascular surgery data significantly underestimates patient workload. Accuracy varies greatly between hospitals, highlighting a need for improved data collection methods in vascular surgery audits.
Area of Science:
- Vascular Surgery
- Health Informatics
- Medical Auditing
Background:
- Centralized Office of Population Censuses and Surveys (OPCS) codes are used for national health data recording.
- The accuracy of these codes for vascular surgery procedures has not been thoroughly evaluated.
- District returns form the basis of centrally recorded OPCS data.
Purpose of the Study:
- To assess the accuracy of centrally recorded OPCS codes for vascular surgery.
- To compare prospectively collected audit data with national health records.
- To identify discrepancies in the recording of vascular and endovascular procedures.
Main Methods:
- Prospective audit data from five UK hospitals were collected over a 12-month period (April 1994-March 1995).
- Audit data were compared with corresponding data from the Department of Health and Welsh Office.
- Specific procedures, including abdominal aortic aneurysm (AAA) repairs and endovascular procedures, were examined.
Main Results:
- A significant underestimation of vascular workload was found, with OPCS codes recording 743 procedures compared to 1082 in audit data (-31.3% discrepancy).
- Specific examples, such as AAA repairs, showed substantial underreporting (38 repairs vs. 2 recorded codes).
- While OPCS codes underestimated workload, they did reflect the relative workload distribution among hospitals.
Conclusions:
- Centralized OPCS code recording markedly underestimates the true workload in vascular surgery.
- There is considerable variation in the accuracy of data submitted by different hospitals.
- The findings suggest a need for re-evaluation and improvement of national health data recording systems for surgical specialties.
Aim:
Centrally recorded OPCS codes are based upon district returns. The aim of this study is to determine the accuracy of this system with regard to vascular surgery.
Methods:
Prospectively recorded audit data for vascular and endovascular procedures were compared with those obtained from the Department of Health and Welsh Office. Five U.K. hospitals were involved in the study. Data were obtained for the twelve months, 1 April 1994-30 March 1995 (these being the most up to date figures available).
Results:
The total number of arterial reconstructions based on audit data was 1082. Those recorded by the OPCS codes were 743. This represents a discrepancy of -31.3% (range for the five hospitals: -13.1% to -63.8%). When examining specific codes similar discrepancies were seen. For example, in one hospital 38 AAA repairs were carried out but only two were centrally recorded. However, examination of ICD9 codes (relating to hospital admissions) for that hospital showed that 38 patients with AAA were admitted. A similar wide variation was seen when examining iliac and superficial femoral artery endovascular procedures. Despite the discrepancies of audit and OPCS data, the codes for reconstructions did reflect relative workload of the different hospitals.
Conclusion:
This study shows that there is a marked underestimate of vascular workload when comparing central recorded data with that obtained from local audit. Marked variation is seen in the accuracy of data submitted from different hospitals.