Methods Inf Med 1989; 28(03): 142-147
DOI: 10.1055/s-0038-1635560
Original Article
Schattauer GmbH

Study on the Accuracy of Official Recording of Nosological Codes in an Italian Regional Hospital Registry

G. Lovison
1   Dipartimento di Scienze Statistiche, Universita’ di Padova, Italy
,
P. Bellini
1   Dipartimento di Scienze Statistiche, Universita’ di Padova, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
14. Februar 2018 (online)

Abstract:

This paper describes an analysis of the quality of hospital discharge data stored in an Italian regional registry.

Although limited in scope, this analysis sheds some light on the level of quality that users can expect in official health data and describes some factors which can influence such quality. Attention focuses on the accuracy with which official administrators code Diseases of Circulatory System (DCS) in a specified health district, using the discharge diagnosis formulated on the case-notes.

Investigation of the data, a random sample of 993 medical records, shows a disturbing level of inaccuracy in the assignment of the primary diagnosis to the (DCS) group and sub-groups, especially when compared with other international experiences.

Two factors, namely the type of hospital where official administrators routinely collect the data and the age of the in-patients, are found to significantly influence such inaccuracy.

Explanations of these findings are suggested and proposals for the improved accuracy of hospital discharge data are presented.

 
  • REFERENCES

  • 1 De Rosis F. Regional and national hospital statistics. In Lambert PM, Roger FH. ed Hospital Statistics in Europe . Amsterdam: North Holland; 1982: 137-45.
  • 2 Acheson RM, Hall DJ, Aird L. Seminars in Community Medicine. Health Information, Planning, Monitoring Vol. 2. London: Oxford University Press; 1976
  • 3 Alderson M. An Introduction to Epidemiology. London: The MacMillan Press Ltd; 1976
  • 4 Bailey TC. Information and decision support systems in the National Health Service. The Statistician 1985; 34: 117-24.
  • 5 Eriksson CG, Granvik M, Kindblad I. et al. Health problem in a Swedish county. What can we learn from official sources?. Soc Sci Med 1981; 15 C 143-51.
  • 6 MacMahon B, Push TF. Epidemiology. Principles and Methods. Boston: Little Brown and Company; 1970
  • 7 Bailar SA. Quality issue in measurement. Intern Stat Rev 1985; 53: 123-40.
  • 8 Bellini P, Lovison G. Primi risultati di una indagine statistica sulla accuratezza dei dati nosologici ospedalieri di livello regionale. In: Atti della XXXIII Riunione Scientifica della Societa’ Italiana di Statistica Vol.2. Bari: Cacucci; 1986: 265-71.
  • 9 Demlo LK, Campbell PM, Brown SS. Reliability of information abstracted from patients’ medical records. Med Care 1978; 16: 995-1005.
  • 10 Demlo LK, Campbell PM. Improving hospital discharge data: lesions from the National Hospital Discharge Survey. Med Care 1981; 19: 1030-40.
  • 11 George AM, Maddocks GB. Accuracy of diagnostic content of Hospital Activity Analysis in infectious diseases. Br Med J 1979; 1: 1332-4.
  • 12 Hsia DC, Krushat WM, Fagan AB. et al. Accuracy of diagnostic coding for Medicare patients. N Eng J Med 1988; 318: 352-5.
  • 13 Jürgensen HJ, Frølund C, Gustafsen J. et al. Registration of Diagnoses in the Danish National Registry of Patients. Meth Inf Med 1986; 25: 158-64.
  • 14 Lloyd SS, Rissing JP. Physicians and coding errors in patient records. JAMA 1985; 254: 1330-6.
  • 15 O’Gorman J. Data accuracy and reliability. In Lambert PM, Roger FH. ed Hospital Statistics in Europe . Amsterdam: North-Holland; 1982: 113-7.
  • 16 Roos LL, Roos NP, Cageorge SM, Nicol JP. et al. How good are the data? Reliability of one health care data bank. Med Care 1982; 20: 266-76.
  • 17 Stevenson CH. What degree of error in Hospital Activity Analysis clinical data?. Public Health, London 1982; 96: 137-40.
  • 18 Bellini P, Lovison G. Square concordance tables in health data analysis. Rev St Appl 1988; 4: 443-58.
  • 19 O’Connel DL, Dobson AJ. General observer-agreement measurement on individual subjects. Biometrics 1984; 40: 973-83.
  • 20 Bandigwala IS. A graphical test for observer agreement. In: Contributed Papers of 45th Session of the International Statistical Institute Book 1. Amsterdam: ISI; 1985: 307-8.
  • 21 Dobson AJ. An Introduction to Statistical Modelling. London: Chapman and Hall; 1983