How accurate is the data provided to the Irish hip fracture database?
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National databases, such as the Irish Hip Fracture Database (IHFD), are known to contain inaccuracies. The coordination of services, national funding and future research rely on the integrity of the IHFD so as to avoid policy and budget planning being based on misrepresentative data. An audit was performed to assess the accuracy of the 2016 IHFD data collected in our trauma unit. The Hospital In-Patient Enquiry (HIPE)-recorded fracture classification, IHFD-recorded fracture classification and IHFD-recorded operation performed for each hip fracture patient was identified. Each variable was compared with the classifications and procedures derived by the authors. Two hundred fifty-two cases were identified. The HIPE-recorded fracture classification was accurate in 29% of cases, and the IHFD-recorded fracture classification in 61% (p < 0.001). The IHFD-recorded operation performed was accurate in 76% of cases. Thirty-six cases (14%) were omitted by HIPE, and eight (3%) from the local IHFD (p < 0.001). Errors resulted from poor documentation, in determining the presence of fracture displacement, prosthesis coating and intramedullary nail length. Diagnoses and procedures were identified from ward and theatre logbooks that the data coordinator was unable to record. The data coordinator in our unit doubled the accuracy of the data, and reduced the rate of omitted cases by a factor of 4.5. Accuracy levels would be significantly improved with clear, thorough documentation by the medical team following education of junior surgical trainees on hip fracture classification and procedural coding. Inaccurate data has a negative effect on hospital reimbursement and compromises the integrity of the IHFD.
KeywordsHip fracture Irish Hip Fracture Database National Database Documentation Accuracy Audit
This study did not require any funding.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 1.Irish Hip Fracture Database (IHFD): (2015) Irish hip fracture database National Report 2013; better, safer care. National Office of clinical auditGoogle Scholar
- 2.Irish Hip Fracture Database (IHFD): (2016) Irish hip fracture database National Report 2015; better, safer care. National Office of Clincal auditGoogle Scholar
- 3.National Model of Care for Trauma and Orthopaedic Surgery. (2015)National Clincal Programme for Trauma and Orthopaedic SurgeryGoogle Scholar
- 4.The Care of Patients with Fragility Fracture.(2007) British Orthopaedic AssociationGoogle Scholar
- 5.Strategy to prevent falls and fractures in Ireland’s ageing population: summary, conclusions and recommendations. (2008) Department Of Health, Health Service ExecutiveGoogle Scholar
- 11.HIPE Portal Data entry/Hip Fracture Admission (V4.0.2*). (2015) Healthcare Pricing. OfficeGoogle Scholar
- 12.Jones MA, Newell C, Howard PW. (2012) Comparison of revision hip and knee arthroplasty data accuracy in the NJR, HES and local theatre records. J Bone Joint Surg [Br]. ; 94-B (Suppl:xxix 2)Google Scholar
- 13.Palmer AJR, Dimbylow D, Giritharan S. (2012) How accurate is national joint registry data? J Bone Joint Surg [Br].94-B (Suppl xxix 73)Google Scholar
- 17.Integrated Care Pathway for Hip Fracture (2015) National Integrate Care Pathway Working Group. In: Health Service ExecutiveGoogle Scholar
- 22.vanWalraven C, Austin P (2012) Administrative database research has unique characteristics that can risk biased results. J Clin Epidemiol 65(126–32)Google Scholar
- 26.Neuburger J, Currie C, Wakeman R, Tsang C, Plant F, Stavola BD et al (2015) The impact of a national clinician-led audit initiative on care and mortality after hip fracture in England: an external evaluation using time trends in non-audit data. Med Care 53:686–691CrossRefPubMedPubMedCentralGoogle Scholar