Chief Complaint

Concern over oral health-related ED visits stems from the increasing number of unemployed and uninsured, the cost burden of these visits, and the unavailability of indicated dental care in EDs [1]. Of particular interest to NC state public health planners are Medicaid-covered visits. Syndromic data in biosurveillance systems offer a means to quantify these visits overall and by county and age group.

Objective

The objective was to use syndromic surveillance data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool NCDETECT and from BioSense to quantify the burden on North Carolina (NC) emergency departments of oral health-related visits more appropriate for care in a dental office (ED). Calculations were sought in terms of the Medicaid-covered visit rate relative to the Medicaid-eligible population by age group and by county.

The NJ syndromic surveillance system, EpiCenter, developed an algorithm to quantify HRI visits using chief complaint data. While heat advisories are released by the National Weather Service, an effective HRI algorithm could provide real-time health impact information that could be used to provide supplemental warnings to the public during a prolonged heat wave.

Objective:

The purpose of this evaluation is to characterize the relationship between a patient’s initial hospital emergency room chief complaint potentially related to a heat-related illness (HRI) with final primary and secondary ICD-9 diagnoses.

 

Maine has been conducting syndromic surveillance since 2007 using the Early Aberration Reporting System (EARS). An evaluation of the syndromic surveillance system was conducted to determine if system objectives are being met, assess the system’s usefulness, and identify areas for improvement. According to CDC’s Guidelines for Evaluating Public Health Surveillance Systems, a surveillance system is useful if it contributes to the timely prevention and control of adverse health events. Acceptability includes the willingness of participants to report surveillance data; participation or reporting rate; and completeness of data.

Objective:

To assess the usefulness and acceptability of Maine’s syndromic surveillance system among hospitals who currently participate.

 

Syndromic surveillance data has predominantly been used for surveillance of infectious disease and for broad symptom types that could be associated with bioterrorism. There has been a growing interest to expand the uses of syndromic data beyond infectious disease. Because many of these conditions are specific and can be swiftly diagnosed (as opposed to infectious agents that require a lab test for confirmation) there could be added value in using the ICD9 ED discharge diagnosis field collected by SS. However, SS discharge diagnosis data is not complete or as timely as chief complaint data. Therefore, for the time being SS chief complaint data is relied on for non-infectious disease surveillance. SPARCS data are based on clinical diagnoses and include information on final diagnosis, providing a means for comparing the chief complaint (from SS) to a diagnosis code (from SPARCS), for evaluating how well the syndrome is captured by SS and for assessing if it would be advantageous to get SS ED diagnosis codes in a more timely and complete manner.

Objective:

To evaluate several non-infectious disease related syndromes that are based on chief complaint (cc) emergency department (ED) syndromic surveillance (SS) data by comparing these with the New York Statewide Planning and Research Cooperative System (SPARCS) clinical diagnosis data. In particular, this work compares SS and SPARCS data for total ED visits and visits associated with three noninfectious disease syndromes, namely asthma, oral health and hypothermia.

 

The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) receives daily ED data from 49 of NYC’s 52 hospitals, representing approximately 95% of ED visits citywide. Chief complaint (CC) is categorized into syndrome groupings using text recognition of symptom key-words and phrases. Hospitals are not required to notify the DOHMH of any changes to procedures or health information systems (HIS). Previous work noticed that CC word count varied over time within and among EDs. The variations seen in CC word count may affect the quality and type of data received by the DOHMH, thereby affecting the ability to detect syndrome visits consistently.

Objective

To identify changes in emergency department (ED) syndromic surveillance data by analyzing trends in chief complaint (CC) word count; to compare these changes to coding changes reported by EDs; and to examine how these changes might affect the ability of syndromic surveillance systems to identify syndromes in a consistent manner.