Assessing Pituitary Surgery Practices: The Value and Limitations of Hospital Administrative Data

Hospital administrative databases hold valuable potential for assessing patterns of surgical care, outcomes, and overall quality. However, the successful use of this data hinges on its accuracy and completeness. A recent study led by Wahba et al. (2023) evaluated whether hospital administrative data can sufficiently assess pituitary surgery practices in England.

The Study

This research, published in the British Journal of Neurosurgery, analysed Hospital Episode Statistics (HES) data from April 2013 to March 2018. The data comprised adult patients in England who had undergone pituitary surgery. The researchers assessed data quality indicators, including attribution of cases to consultants, coding of sellar and parasellar lesions, associated endocrine and visual disorders, and surgical procedures. They then compared data quality over time and between neurosurgical units.

The Findings

From the HES data, 5613 records detailing pituitary procedures were identified. A striking 97.3% of these records included a diagnostic code for the treated tumour or lesion. Meanwhile, 29.7% and 17.8% of records described endocrine and visual disorders, respectively.

The study revealed a significant reduction in records containing only a pituitary tumour code from the first year to the fifth year (63.7% to 47.0%). Furthermore, the use of procedure codes that attracted the highest tariff increased over time (66.4% to 82.4%). However, the patterns of coding varied widely across the 24 neurosurgical units.

Conclusion: The Need for Quality Assurance in Data

The quality of HES data on pituitary surgery has improved over time, suggesting that hospital administrative data has the potential to contribute to healthcare research and quality improvement programmes. However, the broad variation in data quality between neurosurgical units necessitates caution.

Research studies and quality improvement initiatives leveraging this data must ensure that it is of sufficient quality and does not invalidate their results. Ensuring data accuracy, completeness, and uniformity across healthcare units remains a critical task for healthcare administrators and researchers alike.

Citation:

Wahba, A. J., Cromwell, D. A., Hutchinson, P. J., Mathew, R. K., & Phillips, N. (2023). Assessing national patterns and outcomes of pituitary surgery: is hospital administrative data good enough? British Journal of Neurosurgery. https://doi.org/10.1080/02688697.2023.2170982

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