A multicenter study of the coding accuracy of hospital discharge administrative data for patients admitted to cardiac care units in Ontario
A multicenter study of the coding accuracy of hospital discharge administrative data for patients admitted to cardiac care units in Ontario
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DOI：
10.1067/mhj.2002.123839
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发表时间：
2002-08-01
影响因子：
4.8
通讯作者：
Tu, JV
中科院分区：
文献类型：
--
作者：
Austin, PC;Daly, PA;Tu, JV
背景心脏健康服务研究人员经常使用来自行政医院出院摘要数据的队列来研究冠状动脉疾病的结果和治疗。然而，关于出院摘要数据中心脏诊断编码的准确性的数据相对有限。本研究的目的是检验加拿大卫生信息研究所出院摘要中急性心肌梗死和其他心脏诊断编码的准确性。方法将参加FasTrak 11急性冠脉综合征登记的安大略省58个心脏监护病房(CCU)的患者链接到CIHI出院摘要。结果共有58816例CCU患者链接到出院摘要数据。诊断急性心肌梗死的特异性、敏感性和阳性预测值分别为92.8%、88.8%和88.5%。CIHI诊断代码对心律失常、充血性心力衰竭、不稳定心绞痛和尚未诊断的胸痛的特异度均至少为93.9%。然而，这些CIHI诊断代码的敏感度不超过60.7%。且阳性预测值均不大于80.8%。结论安大略省出院摘要数据中心肌梗死的编码基本准确。然而，其他心脏诊断在放电摘要数据中编码的可靠性较低。
Background Cardiac health services researchers frequently use cohorts derived from administrative hospital discharge abstract data to study the outcomes and treatment of coronary artery disease. However, relatively limited data exist on the accuracy of the coding of cardiac diagnoses in discharge abstract data. The goal of this study was to examine the accuracy of the coding of acute myocardial infarction and other cardiac diagnoses in the Canadian Institute of Health Information hospital discharge abstracts.Methods Patients admitted to 58 cardiac care units (CCUs) in Ontario that participated in the Fastrak 11 Acute Coronary Syndromes registry were linked to CIHI hospital discharge abstracts. The most responsible diagnosis at hospital discharge in the administrative data was compared with the CCU discharge diagnosis in the clinical registry.Results A total of 58,816 CCU patients were linked to hospital discharge abstract data. The specificity, sensitivity, and positive predictive value of a most responsible diagnosis of acute myocardial infarction were 92.8%, 88.8%, and 88.5%, respectively. The specificity of CIHI diagnosis codes for arrhythmia, congestive heart failure, unstable angina, and chest pain not yet diagnosed were all at least 93.9%. However, the sensitivity of these CIHI diagnosis codes was no greater than 60.7%. Furthermore, the positive predictive values were no larger than 80.8%.Conclusion Myocardial infarction is generally accurately coded in Ontario hospital discharge abstract data. However, other cardiac diagnoses are less reliably coded in discharge abstract data.