Creating a linked dataset to explore patient outcomes after leaving ambulance care

Crum, Annabel and Coster, Jo and Turner, Janette and Siriwardena, A. Niroshan (2017) Creating a linked dataset to explore patient outcomes after leaving ambulance care. Emergency Medicine Journal, 34 . e6-e6. ISSN 1472-0205

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Creating a linked dataset to explore patient outcomes after leaving ambulance care

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Abstract

Background
Most English ambulance services have implemented electronic patient report forms (ePRF), enabling electronic capture of patient information; previously all information was collected using paper forms. This development brings new opportunities, including linking ambulance data to patient information post ambulance discharge and improving ambulance quality measures. This research aims to create a linked ambulance service, A and E, inpatient and mortality dataset.

Methods
EMAS supplied CAD operational and ePRF clinical data from the study period to the University of Sheffield, and patient identifiers (name, date of birth, address, NHS number) to NHS Digital. NHS Digital traced missing NHS numbers, retrieved patient-level HES A and E, HES inpatient, and ONS mortality data, and returned this data to the University of Sheffield. We created a linked ambulance service and subsequent care dataset by linking EMAS clinical information to data from NHS Digital. This allows us to identify subsequent recontacts, A and E attendances, admissions and deaths.

Results
Our sample comprised only calls recorded via ePRF plus Hear and Treat – excluding 38.90% of total calls. 80.06% of patients in our sample were successfully traced by NHS Digital; unsuccessful traces were due to missing or incomplete CAD/ePRF data. Only CAD identifiers were available for hear and treat patients, limiting tracing success. Non-traced patients could not be linked to HES/ONS data. Of the successfully traced patients, 94.61% were linked to at least one record in the HES or mortality data.

Conclusions
We successfully created a linked dataset for 154927 EMAS patients. This can be used to identify patient outcomes after leaving ambulance care and to develop and test new ways of monitoring ambulance service care quality and performance. Missing information was problematic for data linkage and may be more common among patients who were unable to provide personal details on scene e.g. sicker patients or those who died.

Additional Information:Poster presentation, 999 EMS Research Forum Conference, The Way Forward for Emergency Care Research: Inclusion; Collaboration; Sustainability. Bristol Science Centre, 29th March 2017.
Keywords:ambulance, EMS, Emergency Medical Services, prehospital, data linkage, survival, predictive models
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
B Subjects allied to Medicine > B780 Paramedical Nursing
Divisions:College of Social Science > School of Health & Social Care
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ID Code:29423
Deposited On:08 Nov 2017 17:24

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