@article{ref1,
title="Validity of referral hospitals for the toxicovigilance of acute poisoning in Sri Lanka",
journal="Bulletin of The World Health Organization",
year="2012",
author="Senarathna, L. and Buckley, Na and Jayamanna, Sf and Kelly, Pj and Dibley, Mj and Dawson, Ah",
volume="90",
number="6",
pages="436-443A",
abstract="OBJECTIVE: To identify the hospital admission data set that best captures the incidence of acute poisoning in rural Sri Lanka. METHODS: Data were collected on all acute poisoning cases admitted to 34 primary and 1 referral hospital in Anuradhapura district from September 2008 to January 2010. Three admission data sets were compared with the &quot;true&quot; incidence of acute poisoning to determine the systematic bias inherent to each data set. &quot;True&quot; incidence was calculated by adding all direct admissions (not transfers) to primary hospitals and to the referral hospital. The three data sets were: (i) all admissions to primary hospitals only; (ii) all admissions to the referral hospital only (direct and referrals), and (iii) all admissions to both primary hospitals and the referral hospital (&quot;all admissions&quot;). The third is the government's routine statistical method but counts transfers twice, so for the study transferred patients were counted only once through data linkage. FINDINGS: Of 3813 patients admitted for poisoning, 3111 first presented to a primary hospital and 2287 (73.5%) were later transferred to the referral hospital, where most deaths (161/177) occurred. All data sets were representative demographically and in poisoning type, but referral hospital data yielded a more accurate case-fatality rate than primary hospital data or &quot;all admissions&quot; data. Admissions to primary hospitals only or to the referral hospital only underestimated the incidence of acute poisoning by about 20%, and data on &quot;all admissions&quot; overestimated it by 60%. CONCLUSION: Admission data from referral hospitals are easily obtainable and accurately reflect the true poisoning incidence.<p /> <p>Language: en</p>",
language="en",
issn="0042-9686",
doi="10.2471/BLT.11.092114",
url="http://dx.doi.org/10.2471/BLT.11.092114"
}