Agreement between routine electronic hospital discharge and Scottish Stroke Care Audit (SSCA) data in identifying stroke in the Scottish population

Melanie Turner, Mark Barber, Hazel Dodds, Dennis Martin, Peter Langhorne, Mary Macleod

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In Scotland all non-obstetric, non-psychiatric acute inpatient and day case stays are recorded by an administrative hospital discharge database, the Scottish Morbidity Record (SMR01). The Scottish Stroke Care Audit (SSCA) collects data from all hospitals managing acute stroke in Scotland to support and improve quality of stroke care. The aim was to assess whether there were discrepancies between these data sources for admissions from 2010 to 2011.
Records were matched when admission dates from the two data sources were within two days of each other and if an International Classification of Diseases (ICD) code of I61, I63, I64, or G45 was in the primary or secondary diagnosis field on SMR01. We also carried out a linkage analysis followed by a case-note review within one hospital in Scotland.
There were a total of 22 416 entries on SSCA and 22 200 entries on SMR01. The concordance between SSCA and SMR01 was 16 823. SSCA contained 5593 strokes that were not present in SMR01, whereas SMR01 contained 185 strokes that were not present in SSCA. In the case-note review the concordance was 531, with SSCA containing 157 strokes that were not present in SMR01 and SMR01 containing 32 strokes that were not present in SSCA.
When identifying strokes, hospital administrative discharge databases should be used with caution. Our results demonstrate that SSCA most accurately represents the number of strokes occurring in Scotland. This resource is useful for determining the provision of adequate patient care, stroke services and resources, and as a tool for research.
Original languageEnglish
Article number583
Number of pages5
JournalBMC Health Services Research
Early online date30 Dec 2015
Publication statusPublished - 30 Dec 2015

Bibliographical note

Date of Acceptance: 17/12/2015

This study was funded by Chest, Heart and Stroke Scotland. The SSCA is funded by NHS Scotland via ISD. Neither funder had any role in the analysis. We are grateful to David Murphy of SSCA and to Health Intelligence Grampian for providing data and to Lynsey Waugh of ISD Scotland for linking the SSCA data with SMR01 data.


  • data validity
  • stroke
  • admission


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