title: Use of hospital discharge data to evaluate notifiable disease reporting to Colorado's Electronic Disease Reporting System.
abstract: OBJECTIVE
  Notifiable disease surveillance systems are critical for communicable disease control, and accurate and timely reporting of hospitalized patients who represent the most severe cases is important. A local health department in metropolitan Denver used inpatient hospital discharge (IHD) data to evaluate the sensitivity, timeliness, and data quality of reporting eight notifiable diseases to the Colorado Electronic Disease Reporting System (CEDRS).
  
  
  METHODS
  Using IHD data, we detected hospitalized patients admitted from 2003 through 2005 with a discharge diagnosis associated with one of eight notifiable diseases. Initially, we compared all cases identified through IHD diagnoses fields with cases reported to CEDRS. Second, we chose four diseases and conducted medical record review to confirm the IHD diagnoses before comparison with CEDRS cases.
  
  
  RESULTS
  Relying on IHD diagnoses only, shigellosis, salmonellosis, and Neisseria meningitidis invasive disease had high sensitivity (> or = 90%) and timeliness (> or = 75%); legionellosis, pertussis, and West Nile virus infection were intermediate; and hepatitis A and Haemophilus influenzae (H. influenzae) invasive disease had low sensitivity (> or = 25%) and timeliness (< or = 33%). Medical record review improved the sensitivity to > or = 90% and timeliness to > or = 80% for H. influenza invasive disease, legionellosis, and pertussis; however, hepatitis A retained suboptimal sensitivity (67%) and timeliness (25%).
  
  
  CONCLUSIONS
  Hospital discharge data are useful for evaluating notifiable disease surveillance systems. Limitations encountered by using discharge diagnoses alone can be overcome by conducting medical record review. Public health agencies should conduct periodic surveillance system evaluations among hospitalized patients and reinforce notifiable disease reporting among the people responsible for this activity.
authors.affiliation: Centers for Disease Control and Prevention, 4770 Buford Hwy. NE, MS F-58, Atlanta, GA 30341, USA. tboehmer@cdc.gov
authors.forename: Tegan K
authors.initials: TK
authors.lastname: Boehmer
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Patnaik
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Burnite
authors.forename: Tista S
authors.initials: TS
authors.lastname: Ghosh
authors.forename: Ken
authors.initials: K
authors.lastname: Gershman
authors.forename: Richard L
authors.initials: RL
authors.lastname: Vogt
mesh_terms: D003120:Colorado / Q000453:epidemiology; D018563:Disease Notification / Q000379:methods*; D057286:Electronic Health Records / Q000458:organization & administration*; D006192:Haemophilus Infections / Q000453:epidemiology; D006506:Hepatitis A / Q000453:epidemiology; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D038801:International Classification of Diseases; D007876:Legionellosis / Q000453:epidemiology; D008485:Medical Audit / Q000379:methods; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011159:Population Surveillance / Q000379:methods*; D015397:Program Evaluation; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D013997:Time Factors; D014901:West Nile Fever / Q000453:epidemiology; D014917:Whooping Cough / Q000453:epidemiology