Percentage of provider spells with an invalid primary diagnosis code Indicator specification Indicator code: I01963 Version: 1.2 Issue date: 19 th July 2017 Author: Clinical Indicators Team, NHS Digital Copyright 2017 Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.
Version history Version Date Details 1.0 24 th February 2016 First release. 1.1 1 st December 2016 Moved content to new NHS Digital corporate template. Removed HES-ONS linked mortality data from Data sources as this is not required for the calculation of this indicator. 1.2 19 th July 2017 Added section on small number suppression. Updates to ensure consistency with SHMI specification. Copyright 2017 Health and Social Care Information Centre. 2
Contents Version history 2 Overview 4 Data 5 Data processing 6 Indicator calculation 7 Presentation 8 Small number suppression 8 Queries and comments 9 Copyright 2017 Health and Social Care Information Centre. 3
Overview Indicator title Percentage of provider spells with an invalid primary diagnosis code Indicator code I01963 Indicator family name Summary Hospital-level Mortality Indicator (SHMI) Reporting frequency Quarterly Description This is an indicator designed to accompany the Summary Hospital-level Mortality Indicator (SHMI). Using the same spell level data as the SHMI, this indicator presents the percentage of finished provider spells with an invalid primary diagnosis code. These spells are identified as those where the primary diagnosis is given by the ICD-10 code R69X 1. In normal circumstances, the diagnosis code R69X is not used by trusts when they submit data to the Secondary Uses Service (SUS). Episodes which are submitted by trusts without a valid primary diagnosis code are allocated the primary diagnosis code R69X as part of the Hospital Episode Statistics (HES) automated data cleaning rules. Further details can be found in the HES Inpatient Cleaning Rules documentation (rules 500 and 510) 2. A high percentage of provider spells with a primary diagnosis of R69X compared to other trusts may indicate a data quality problem. For spells which consist of multiple episodes, the primary diagnosis is taken from the same episode as that used to derive the primary diagnosis for the calculation of the SHMI 3. 1 Details of the World Health Organisation (WHO) International Classification of Diseases (ICD) can be found at http://www.who.int/classifications/icd/en/. 2 Details of the HES inpatient data cleaning rules are available at http://digital.nhs.uk/article/1825/the-processing-cycle-and- HES-data-quality. 3 Full details of the methodology used in the calculation of the SHMI are provided in the SHMI methodology specification, which is available to download from http://digital.nhs.uk/shmi. Copyright 2017 Health and Social Care Information Centre. 4
Data Data sources Hospital Episode Statistics (HES) provider spells dataset 4, NHS Digital Data fields This indicator is calculated from the same spell level data as the SHMI (I00699). A list of the data fields that are required for the calculation of this contextual indicator can be found in the SHMI methodology specification document, which is available to download from http://digital.nhs.uk/shmi. 4 Further information on the HES provider spells dataset is available at http://digital.nhs.uk/shmi. Copyright 2017 Health and Social Care Information Centre. 5
Data processing This indicator is calculated from the same spell level data as the SHMI (I00699). Details of the data filters and data processing required for the calculation of this indicator can be found in the SHMI methodology specification document, which is available to download from http://digital.nhs.uk/shmi. The following additional data processing is applied for the purposes of calculating this indicator. Data filter Field name: Condition: Rationale: P_SPELL_DISDATE P_SPELL_DISDATE >= first day in the reporting period AND P_SPELL_DISDATE <= last day in the reporting period Selects spells with a discharge date in the reporting period from the threeyear dataset used in the construction of the SHMI statistical models. Copyright 2017 Health and Social Care Information Centre. 6
Indicator calculation The following rate is calculated for each trust p: where R69X_RATE p = R69X _SPELLS p SPELLS p 100 R69X_SPELLS p = count of those provider spells where DIAG_01 = R69X for trust p, SPELLS p = count of all provider spells for trust p. Copyright 2017 Health and Social Care Information Centre. 7
Presentation Table 1 provides details of the csv output data from the indicator calculations at trust level. Table 1: csv output table for percentage of provider spells with an invalid primary diagnosis code Field name Type Length Source / details INDICATOR_CODE CHAR 6 I01963 PROVIDER_CODE CHAR 3 Trust code given by the PROCODET_MAPPED field PROVIDER_NAME CHAR 100 The name of the trust corresponding to the PROVIDER_CODE NUMERATOR INT R69X_SPELLS p, the number of spells with an invalid primary diagnosis code for trust p DENOMINATOR INT SPELLS p, the number of spells for trust p RATE FLOAT R69X_RATE p, the percentage of spells with an invalid primary diagnosis code for trust p Note: INDICATOR_CODE will be the same for all records. Small number suppression No small number suppression is applied to this indicator as the information presented is not considered to be disclosive. Copyright 2017 Health and Social Care Information Centre. 8
Queries and comments We welcome queries and comments on the methodology set out in this specification. Please email them to enquiries@nhsdigital.nhs.uk (quoting SHMI in the subject line of your email). All comments and suggestions will be considered as part of the continuous review process for this indicator. Every effort has been made to ensure that this specification is definitive and clearly states the methodology which NHS Digital will follow to construct the indicator from the stated data sources. In the event that there is an error or omission in the written content of this specification, it will be updated under full version control and the new version republished on the NHS Digital website. Copyright 2017 Health and Social Care Information Centre. 9