Reliability of comorbidity scores derived from administrative data in the tertiary hospital intensive care setting: a cross-sectional study
Reliability of comorbidity scores derived from administrative data in the tertiary hospital intensive care setting: a cross-sectional study
复制标题
DOI：
10.1136/bmjhci-2019-000016
复制
发表时间：
2019-02-01
影响因子：
4.1
通讯作者：
Duke, Graeme
中科院分区：
文献类型：
--
作者：
Li, Michael Hua-Gen;Hutchinson, Anastasia;Duke, Graeme
背景医院报告系统通常使用行政数据来计算合并症评分，以便为结局指标提供风险调整。目的我们旨在阐明行政编码数据和医学图表审查之间的一致性水平，以提取大学重症监护病房患者的Charlson合并症指数（CCI）和Elixhauser指数（EI）中的合并症。方法我们对12个月（2012年7月至2013年6月）内100例患者的随机横断面进行了检查，以了解管理数据和手动病历系统中报告的19种CCI和30种EI合并症。CCI和EI合并症被收集，以确定平均指数的差异，检测任何系统偏倚，并确定评分者间的agreement.Results结果我们发现，合理的评分者间一致性（kappa（kappa）系数>= 0.4）的心肺和肿瘤合并症，但很少一致性（kappa
Background Hospital reporting systems commonly use administrative data to calculate comorbidity scores in order to provide risk-adjustment to outcome indicators.Objective We aimed to elucidate the level of agreement between administrative coding data and medical chart review for extraction of comorbidities included in the Charlson Comorbidity Index (CCI) and Elixhauser Index (EI) for patients admitted to the intensive care unit of a university-affiliated hospital.Method We conducted an examination of a random cross-section of 100 patient episodes over 12months (July 2012 to June 2013) for the 19 CCI and 30 EI comorbidities reported in administrative data and the manual medical record system. CCI and EI comorbidities were collected in order to ascertain the difference in mean indices, detect any systematic bias, and ascertain inter-rater agreement.Results We found reasonable inter-rater agreement (kappa (kappa) coefficient >= 0.4) for cardiorespiratory and oncological comorbidities, but little agreement (kappa