title: Discordance between two national health statistics sources (EMH and EESCRI, 1990-2009). Analysis of psychiatric morbidity.
abstract: BACKGROUND
  Two statistical sources provide data on hospital stays and discharges for all Spanish hospitals: Hospital Morbidity Survey (acronym in Spanish: EMH) and Statistics of Health Establishments providing Inpatient Care (acronym in Spanish: EESCRI). Our aim is to contrast these two statistical sources to define their accuracy and relevance in psychiatric epidemiology studies.
  
  
  METHODS
  The analysis is based on two aspects: 1.- Compare the number of psychiatric stays and hospital discharges from 1990-2009, 2.- Analyze and compare how the average stay is provided.
  
  
  RESULTS
  The differences between the two statistical sources are significant and increase over time. In 2005-2009 the EMH records 121% of hospitalizations (577,078 vs. 475,414) and 46% (14,239,527 vs. 30,821,412) of psychiatric stays, compared with EESCRI. Moreover, the average stay estimated by EESCRI shows serious methodological problems, particularly in settings of prolonged hospitalization (psychiatric hospitals); the estimations are potentially below the real value.
  
  
  CONCLUSIONS
  Surprisingly, the questionnaires completed by hospitals to develop the EESCRI provide data on assisted morbidity quite different from that provided by the EMH, despite both statistical sources having the same inpatient records for data processing. It is difficult to attribute these differences to sampling error, as the EMH has a very high sampling fraction, which minimizes the sampling error. Given the mismatch between sources, we recommend using the EMH, as it offers more reliable data and allows an accurate determination of the length of stays.
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Servicio de Neurología, Hospital 12 de Octubre, Madrid, España. Electronic address: alvaromedel@yahoo.es.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Medel-Herrero
authors.affiliation: Departamento de Medicina, Facultad de Medicina, Universidad de Valencia, CIBERSAM, Valencia, España.
authors.forename: Manuel
authors.initials: M
authors.lastname: Gómez-Beneyto
authors.affiliation: Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Fundación Investigación Biomédica-HCSC, Hospital Clínico San Carlos, Madrid, España.
authors.forename: Zuleika
authors.initials: Z
authors.lastname: Saz-Parkinson
authors.affiliation: Servicio de Psiquiatría y Salud Mental, Hospital Universitario La Paz, IdiPaz, Madrid, España; Departamento de Psiquiatría, Universidad Autónoma de Madrid, Madrid, España.
authors.forename: Maria Fe
authors.initials: MF
authors.lastname: Bravo-Ortiz
authors.affiliation: Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España.
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Amate
mesh_terms: D016208:Databases, Factual; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008499:Medical Records / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D010351:Patient Discharge / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology
keywords: Estadísticas; Hospital; Mental health; Salud mental; Statistics