COMPLETENESS AND ACCURACY OF MORBIDITY AND REPEAT PRESCRIBING RECORDSHELD ON GENERAL-PRACTICE COMPUTERS IN SCOTLAND

Background. A high proportion of Scottish general practices use a stan dard computer software package (GPASS, general practice administration system for Scotland), and thus, Scotland is uniquely placed to amalga mate primary care data on a national scale. Practices, however, vary w idely in the nature and extent of data entered on computer and a major limitation on the use of the collected data is the absence of informa tion on the completeness and accuracy of the computer database. Aim. T his study set out to assess the quality of morbidity and repeat prescr ibing records held on computer by general practices in Scotland. Metho d Forty-one practices, with above average levels of morbidity data rec orded on computer, were selected on a geographic basis in relation to the national population distribution. Within each practice, 250 patien ts aged 45-64 years were selected at random. Data relating to 19 diagn oses, six surgical procedures and 40 repeat prescription drugs were ex tracted from the computer records of these patients and compared with information held on patients' paper records and supplied by patients i n response to a postal questionnaire. The completeness and accuracy of computer entries were assessed in terms of sensitivity and positive p redictive value, respectively. Results. For the 5567 patients for whom all three sources of data (validated computer records, paper records and questionnaire responses) were available, sensitivity (completeness ) of morbidity recording had median values of 0.67 for diagnoses, 0.93 for surgical procedures and 0.75 over all conditions examined. Practi ces varied both in the completeness of recording of each condition and in their overall performance. The predictive value (accuracy) of morb idity data was uniformly high for all conditions examined (median 1.00 ). For repeat prescription drugs, recording on GPASS was both complete and accurate. Conclusion. The recording of morbidity data on GPASS fo r 45-64-year-old patients in a selected group of 41 highly-computerize d practices is about 75% complete and highly accurate. For national mo rbidity studies, it seems likely that amalgamated data from the best G PASS practices will be as complete and accurate as the morbidity stati stics currently derived from hospital-based activities in Scotland.