A study published in BMC Health Services Research, found that long-term conditions are often not recorded on administrative data and the lack of recording may be worse for weekend admissions in the UK. To date, studies of the weekend effect that rely on administrative data might have underestimated the health burden of patients, particularly if admitted at the weekend. Many studies have investigated the presence of a ‘weekend effect’ in mortality following hospital admission, and these frequently use diagnostic codes from administrative data for information on comorbidities for risk adjustment. However, it is possible that coding practice differs between week and weekend. For this study, the researchers assessed patients with a confirmed history of certain long-term health conditions, including chronic pulmonary disease, congestive heart failure, dementia, hemiplegia or paraplegia and metastatic cancer, and investigated how well these are recorded in subsequent week and weekend admissions. Researchers found that patients’ long-term conditions are often not recorded in hospital data. Congestive heart failure was only recorded in 53% of admissions where it was not the main reason for the patient’s admission, while hemiplegia/paraplegia (paralysis) was only recorded in 43% of cases. Of the six long-term conditions looked at, diabetes was the most consistently recorded, but still recorded in only 89% of cases. This was despite NHS coding guidelines, which state that these long-term conditions are clinically relevant and should always be recorded.
In a later opinion piece, the study author cites the above as an example of where there is room for improvement in the quality of hospital data currently being collected.
- Weekend admissions may be associated with poorer recording of long-term comorbidities: a prospective study of emergency admissions using administrative data. BMC Health Services Research. October 2018
- The importance of good-quality hospital data. The Health Foundation. 17 January 2019