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Linking Emergency Medical Services and Emergency Department Data to Improve Overdose Surveillance in North Carolina

INTRODUCTION: Linking emergency medical services (EMS) data to emergency department (ED) data enables assessing the continuum of care and evaluating patient outcomes. We developed novel methods to enhance linkage performance and analysis of EMS and ED data for opioid overdose surveillance in North C...

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Autores principales: Fix, Jonathan, Ising, Amy I., Proescholdbell, Scott K., Falls, Dennis M., Wolff, Catherine S., Fernandez, Antonio R., Waller, Anna E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573781/
https://www.ncbi.nlm.nih.gov/pubmed/34726971
http://dx.doi.org/10.1177/00333549211012400
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author Fix, Jonathan
Ising, Amy I.
Proescholdbell, Scott K.
Falls, Dennis M.
Wolff, Catherine S.
Fernandez, Antonio R.
Waller, Anna E.
author_facet Fix, Jonathan
Ising, Amy I.
Proescholdbell, Scott K.
Falls, Dennis M.
Wolff, Catherine S.
Fernandez, Antonio R.
Waller, Anna E.
author_sort Fix, Jonathan
collection PubMed
description INTRODUCTION: Linking emergency medical services (EMS) data to emergency department (ED) data enables assessing the continuum of care and evaluating patient outcomes. We developed novel methods to enhance linkage performance and analysis of EMS and ED data for opioid overdose surveillance in North Carolina. METHODS: We identified data on all EMS encounters in North Carolina during January 1–November 30, 2017, with documented naloxone administration and transportation to the ED. We linked these data with ED visit data in the North Carolina Disease Event Tracking and Epidemiologic Collection Tool. We manually reviewed a subset of data from 12 counties to create a gold standard that informed developing iterative linkage methods using demographic, time, and destination variables. We calculated the proportion of suspected opioid overdose EMS cases that received International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes for opioid overdose in the ED. RESULTS: We identified 12 088 EMS encounters of patients treated with naloxone and transported to the ED. The 12-county subset included 1781 linkage-eligible EMS encounters, with historical linkage of 65.4% (1165 of 1781) and 1.6% false linkages. Through iterative linkage methods, performance improved to 91.0% (1620 of 1781) with 0.1% false linkages. Among statewide EMS encounters with naloxone administration, the linkage improved from 47.1% to 91.1%. We found diagnosis codes for opioid overdose in the ED among 27.2% of statewide linked records. PRACTICE IMPLICATIONS: Through an iterative linkage approach, EMS–ED data linkage performance improved greatly while reducing the number of false linkages. Improved EMS–ED data linkage quality can enhance surveillance activities, inform emergency response practices, and improve quality of care through evaluating initial patient presentations, field interventions, and ultimate diagnoses.
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spelling pubmed-85737812021-12-24 Linking Emergency Medical Services and Emergency Department Data to Improve Overdose Surveillance in North Carolina Fix, Jonathan Ising, Amy I. Proescholdbell, Scott K. Falls, Dennis M. Wolff, Catherine S. Fernandez, Antonio R. Waller, Anna E. Public Health Rep Public Health Methodology INTRODUCTION: Linking emergency medical services (EMS) data to emergency department (ED) data enables assessing the continuum of care and evaluating patient outcomes. We developed novel methods to enhance linkage performance and analysis of EMS and ED data for opioid overdose surveillance in North Carolina. METHODS: We identified data on all EMS encounters in North Carolina during January 1–November 30, 2017, with documented naloxone administration and transportation to the ED. We linked these data with ED visit data in the North Carolina Disease Event Tracking and Epidemiologic Collection Tool. We manually reviewed a subset of data from 12 counties to create a gold standard that informed developing iterative linkage methods using demographic, time, and destination variables. We calculated the proportion of suspected opioid overdose EMS cases that received International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes for opioid overdose in the ED. RESULTS: We identified 12 088 EMS encounters of patients treated with naloxone and transported to the ED. The 12-county subset included 1781 linkage-eligible EMS encounters, with historical linkage of 65.4% (1165 of 1781) and 1.6% false linkages. Through iterative linkage methods, performance improved to 91.0% (1620 of 1781) with 0.1% false linkages. Among statewide EMS encounters with naloxone administration, the linkage improved from 47.1% to 91.1%. We found diagnosis codes for opioid overdose in the ED among 27.2% of statewide linked records. PRACTICE IMPLICATIONS: Through an iterative linkage approach, EMS–ED data linkage performance improved greatly while reducing the number of false linkages. Improved EMS–ED data linkage quality can enhance surveillance activities, inform emergency response practices, and improve quality of care through evaluating initial patient presentations, field interventions, and ultimate diagnoses. SAGE Publications 2021-11-02 /pmc/articles/PMC8573781/ /pubmed/34726971 http://dx.doi.org/10.1177/00333549211012400 Text en © 2021, Association of Schools and Programs of Public Health
spellingShingle Public Health Methodology
Fix, Jonathan
Ising, Amy I.
Proescholdbell, Scott K.
Falls, Dennis M.
Wolff, Catherine S.
Fernandez, Antonio R.
Waller, Anna E.
Linking Emergency Medical Services and Emergency Department Data to Improve Overdose Surveillance in North Carolina
title Linking Emergency Medical Services and Emergency Department Data to Improve Overdose Surveillance in North Carolina
title_full Linking Emergency Medical Services and Emergency Department Data to Improve Overdose Surveillance in North Carolina
title_fullStr Linking Emergency Medical Services and Emergency Department Data to Improve Overdose Surveillance in North Carolina
title_full_unstemmed Linking Emergency Medical Services and Emergency Department Data to Improve Overdose Surveillance in North Carolina
title_short Linking Emergency Medical Services and Emergency Department Data to Improve Overdose Surveillance in North Carolina
title_sort linking emergency medical services and emergency department data to improve overdose surveillance in north carolina
topic Public Health Methodology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573781/
https://www.ncbi.nlm.nih.gov/pubmed/34726971
http://dx.doi.org/10.1177/00333549211012400
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