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BACKGROUND: Nationwide Environmental Public Health Tracking Network (Tracking Network) utilizes hospital discharge databases (HDD), for health outcome surveillance. Currently, 23 states provide their HDD to the Tracking Network. In 2012, Tracking Network updated to the data storage structure and all states resubmitted HDD data to the Tracking Network. We evaluated HDD, a dataset subject to updates over time, using Centers for Disease Control and Prevention’s surveillance system evaluation guidelines to assess the usefulness, timeliness and completeness of reporting using asthma and acute myocardial infarction (AMI) as examples.
METHODS: We reviewed available HDD variable and data structures and conducted key-informant interviews to assess the usefulness of HDD in Tracking Network states. We compared 2000–2010 HDD received before 2012 (Old submission) with 2000–2010 HDD resubmitted in 2012 (New submission) for 22 states. We assessed timeliness and completeness of reporting to the Tracking Network by calculating yearly percent change in number and age-adjusted rates of asthma (International Classification of Diseases (9th Rev.) codes (ICD-9): 493.XX) and AMI (ICD-9: 410.00 – 410.92 ) hospitalizations between Old and New data submissions.
RESULTS: Our review of HDD indicated that the majority of data elements is similar across states. All key-informant interviews suggested that HDD is a useful existing data source for tracking health outcomes of interest. Only 6 states submitted 2010 data in the Old submission; however, this increased to 16 states in the New submission. During New submission, all but one state updated number and rates of hospitalization for previous years, though the extent varied by state. Across all states, average number of hospitalizations and age-adjusted rates for asthma and AMI varied by <1.15% and <2.10 per year, respectively. Yearly percent change for newest data was wider than for oldest data for age-adjusted rates (Asthma: 2008 range= -1.74–2.77% versus 2000 range= -1.09–1.11%; AMI: 2008 range= -2.88–10.28% versus 2000 range= -2.38–4.25).
CONCLUSIONS: Overall, HDD provides useful existing data which is uniformly collected by all Tracking states. Timeliness of data availability limited the number of states submitting during recent years. Annual updating of number and rates of hospitalizations is necessary to ensure the timeliest data are available for the Tracking Network. We recommend the Tracking Network implement resubmission of 3 years of data annually from all states.