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Hospitalization Records as a Tool for Evaluating Performance of Food- and Water-Borne Disease Surveillance Systems: A Massachusetts Case Study

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  • Siobhan M Mor
  • Alfred DeMaria Jr.
  • Elena N Naumova

Abstract

We outline a framework for evaluating food- and water-borne surveillance systems using hospitalization records, and demonstrate the approach using data on salmonellosis, campylobacteriosis and giardiasis in persons aged ≥65 years in Massachusetts. For each infection, and for each reporting jurisdiction, we generated smoothed standardized morbidity ratios (SMR) and surveillance to hospitalization ratios (SHR) by comparing observed surveillance counts with expected values or the number of hospitalized cases, respectively. We examined the spatial distribution of SHR and related this to the mean for the entire state. Through this approach municipalities that deviated from the typical experience were identified and suspected of under-reporting. Regression analysis revealed that SHR was a significant predictor of SMR, after adjusting for population age-structure. This confirms that the spatial “signal” depicted by surveillance is in part influenced by inconsistent testing and reporting practices since municipalities that reported fewer cases relative to the number of hospitalizations had a lower relative risk (as estimated by SMR). Periodic assessment of SHR has potential in assessing the performance of surveillance systems.

Suggested Citation

  • Siobhan M Mor & Alfred DeMaria Jr. & Elena N Naumova, 2014. "Hospitalization Records as a Tool for Evaluating Performance of Food- and Water-Borne Disease Surveillance Systems: A Massachusetts Case Study," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-8, April.
    • Handle: RePEc:plo:pone00:0093744
    DOI: 10.1371/journal.pone.0093744
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    References listed on IDEAS

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    1. Fisher, E.S. & Baron, J.A. & Malenka, D.J. & Barrett, J. & Bubolz, T.A., 1990. "Overcoming potential pitfalls in the use of Medicare data for epidemiologic research," American Journal of Public Health, American Public Health Association, vol. 80(12), pages 1487-1490.
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    Cited by:

    1. Emily Sanchez & Ryan B. Simpson & Yutong Zhang & Lauren E. Sallade & Elena N. Naumova, 2022. "Exploring Risk Factors of Recall-Associated Foodborne Disease Outbreaks in the United States, 2009–2019," IJERPH, MDPI, vol. 19(9), pages 1-20, April.
    2. Ninon A. Becquart & Elena N. Naumova & Gitanjali Singh & Kenneth K. H. Chui, 2018. "Cardiovascular Disease Hospitalizations in Louisiana Parishes’ Elderly before, during and after Hurricane Katrina," IJERPH, MDPI, vol. 16(1), pages 1-22, December.
    3. Yutong Zhang & Ryan B. Simpson & Lauren E. Sallade & Emily Sanchez & Kyle M. Monahan & Elena N. Naumova, 2022. "Evaluating Completeness of Foodborne Outbreak Reporting in the United States, 1998–2019," IJERPH, MDPI, vol. 19(5), pages 1-19, March.
    4. Aishwarya Venkat & Tania M. Alarcon Falconi & Melissa Cruz & Meghan A. Hartwick & Shalini Anandan & Naveen Kumar & Honorine Ward & Balaji Veeraraghavan & Elena N. Naumova, 2019. "Spatiotemporal Patterns of Cholera Hospitalization in Vellore, India," IJERPH, MDPI, vol. 16(21), pages 1-14, November.

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