Under-coding of secondary conditions in coded hospital health data: Impact of co-existing conditions, death status and number of codes in a record
Under-coding of secondary conditions in coded hospital health data: Impact of co-existing conditions, death status and number of codes in a record
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DOI：
10.1177/1460458216647089
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发表时间：
2017-12-01
影响因子：
3
通讯作者：
Quan, Hude
中科院分区：
文献类型：
--
作者：
Peng, Mingkai;Southern, Danielle A.;Quan, Hude
本研究探讨高血压、糖尿病、肥胖症及抑郁症的编码效度与其并存情况、死亡状况及出院摘要数据库中诊断码数量的关系。我们从加拿大阿尔伯塔的四所教学医院随机选择了4007个出院摘要数据库记录，并回顾了他们的图表，以提取Charlson和Elixhauser合并症指数中列出的31个条件。通过多变量逻辑回归确定与四种研究条件相关的条件。四种疾病的编码有效性（即敏感性、阳性预测值）与其相关疾病的存在有关。灵敏度随着诊断代码数量的增加而增加。死亡对编码有效性的影响很小。条件编码的有效性与其临床重要性和患者病例组合的复杂性密切相关。我们建议对某些次要诊断进行强制性编码，以满足基于行政卫生数据的卫生研究的需要。
This study examined the coding validity of hypertension, diabetes, obesity and depression related to the presence of their co-existing conditions, death status and the number of diagnosis codes in hospital discharge abstract database. We randomly selected 4007 discharge abstract database records from four teaching hospitals in Alberta, Canada and reviewed their charts to extract 31 conditions listed in Charlson and Elixhauser comorbidity indices. Conditions associated with the four study conditions were identified through multivariable logistic regression. Coding validity (i.e. sensitivity, positive predictive value) of the four conditions was related to the presence of their associated conditions. Sensitivity increased with increasing number of diagnosis code. Impact of death on coding validity is minimal. Coding validity of conditions is closely related to its clinical importance and complexity of patients' case mix. We recommend mandatory coding of certain secondary diagnosis to meet the need of health research based on administrative health data.