Linking administrative data sets of inpatient infectious diseases diagnoses in far North Queensland: a cohort profile

Abstract

PurposeTo design a linked hospital database using administrative and clinical information to describe associations that predict infectious diseases outcomes, including long-term mortality.ParticipantsA retrospective cohort of Townsville Hospital inpatients discharged with an International Classification of Diseases and Related Health Problems 10th Revision Australian Modification code for an infectious disease between 1 January 2006 and 31 December 2016 was assembled. This used linked anonymised data from: hospital administrative sources, diagnostic pathology, pharmacy dispensing, public health and the National Death Registry. A Created Study ID was used as the central identifier to provide associations between the cohort patients and the subsets of granular data which were processed into a relational database. A web-based interface was constructed to allow data extraction and evaluation to be performed using editable Structured Query Language.Findings to dateThe database has linked information on 41 367 patients with 378 487 admissions and 1 869 239 diagnostic/procedure codes. Scripts used to create the database contents generated over 24 000 000 database rows from the supplied data. Nearly 15% of the cohort was identified as Aboriginal or Torres Strait Islanders. Invasive staphylococcal, pneumococcal and Group A streptococcal infections and influenza were common in this cohort. The most common comorbidities were smoking (43.95%), diabetes (24.73%), chronic renal disease (17.93%), cancer (16.45%) and chronic pulmonary disease (12.42%). Mortality over the 11-year period was 20%.Future plansThis complex relational database reutilising hospital information describes a cohort from a single tropical Australian hospital of inpatients with infectious diseases. In future analyses, we plan to explore analyses of risks, clinical outcomes, healthcare costs and antimicrobial side effects in site and organism specific infections.

The Australian burden of invasive group A streptococcal disease: a narrative review

“…Because WA has temperate and tropical regions and access to linked clinical and microbiological data, analysis of incidence data from this state could highlight climate‐based variation 47 . An example of this type of linkage from tropical Queensland, including Strep A disease, has recently been published 48 …”

Hospitalisations related to lower respiratory tract infections in Northern Queensland

“…The proportion of the patients in our sample identified as Indigenous is higher than in the population of the Townsville region (during 2006-2016, the percentage of Indigenous peoples varied from 7.1% to 7.8%). 10,11 Indigenous patients were significantly younger than non-Indigenous, with an average age difference of more than 20 years (38.7 years vs. 59.4 years). This also corresponds to the census data that report a 16-year difference in the median age between Indigenous and non-Indigenous Queensland populations.…”

“…Details of the data and linking procedures have been described in detail elsewhere. 10 To control for socioeconomic and environmental measures that may explain the variation in the health outcomes between Indigenous and non-Indigenous populations, we used the Index of Relative Socio-Economic Disadvantage (IRSD) from Socio-Economic Indexes for Areas (SEIFA), which summarises information about the economic and social conditions of people and households within geographical areas. Using the residential postcode information of patients and the year of admission, we supplemented our dataset with the IRSD values that are based on information from the five-yearly Census (2006,2011,2016).…”

Tropical Australian Health-Data Linkage Shows Excess Mortality Following Severe Infectious Disease Is Present in the Short-Term and Long-Term after Hospital Discharge

“…This cohort, subsequently referred to as TSV11, was comprised of 41,367 patients discharged over an 11-year period from the Townsville Hospital. Patients entered the cohort when they were discharged from the hospital with an International Classification of Diseases Version 10 Australian Modification (ICD-10-AM) code for infectious disease ( Table S1 ) [ 6 ]. All TSV11 patient hospitalisation data prior to and after their index admission was available for analysis (between 2006 and 2016).…”

“…We have used linked health data to examine mortality patterns of a cohort of patients discharged from a tropical Northern Australian hospital with a diagnosis of an infectious disease over an 11-year period [ 6 ]. We were particularly interested in assessing mortality that was directly due to severe infectious disease over the short-, medium-, and long-term to understand if preventive strategies may be of value to readdress any differences.…”