Download PDF
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
› Author Affiliations
Further Information

Publication History

Publication Date:
14 February 2018 (online)

  PDF Download  Permissions and Reprints

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.

Key-Words:

Hospital Discharge - Quality Control - Nosological Codes - Inpatient Register - Circulatory System
 

  • 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.
    Search in Google Scholar
  • 2 Acheson RM, Hall DJ, Aird L. Seminars in Community Medicine. Health Information, Planning, Monitoring Vol. 2. London: Oxford University Press; 1976
    Search in Google Scholar
  • 3 Alderson M. An Introduction to Epidemiology. London: The MacMillan Press Ltd; 1976
    Search in Google Scholar
  • 4 Bailey TC. Information and decision support systems in the National Health Service. The Statistician 1985; 34: 117-24.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    PubMedSearch in Google Scholar
  • 6 MacMahon B, Push TF. Epidemiology. Principles and Methods. Boston: Little Brown and Company; 1970
    Search in Google Scholar
  • 7 Bailar SA. Quality issue in measurement. Intern Stat Rev 1985; 53: 123-40.
    PubMedSearch in Google Scholar
  • 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.
    Search in Google Scholar
  • 9 Demlo LK, Campbell PM, Brown SS. Reliability of information abstracted from patients’ medical records. Med Care 1978; 16: 995-1005.
    CrossrefPubMedSearch in Google Scholar
  • 10 Demlo LK, Campbell PM. Improving hospital discharge data: lesions from the National Hospital Discharge Survey. Med Care 1981; 19: 1030-40.
    CrossrefPubMedSearch in Google Scholar
  • 11 George AM, Maddocks GB. Accuracy of diagnostic content of Hospital Activity Analysis in infectious diseases. Br Med J 1979; 1: 1332-4.
    CrossrefPubMedSearch in Google Scholar
  • 12 Hsia DC, Krushat WM, Fagan AB. et al. Accuracy of diagnostic coding for Medicare patients. N Eng J Med 1988; 318: 352-5.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    PubMedSearch in Google Scholar
  • 14 Lloyd SS, Rissing JP. Physicians and coding errors in patient records. JAMA 1985; 254: 1330-6.
    CrossrefPubMedSearch in Google Scholar
  • 15 O’Gorman J. Data accuracy and reliability. In Lambert PM, Roger FH. ed Hospital Statistics in Europe . Amsterdam: North-Holland; 1982: 113-7.
    Search in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 17 Stevenson CH. What degree of error in Hospital Activity Analysis clinical data?. Public Health, London 1982; 96: 137-40.
    CrossrefPubMedSearch in Google Scholar
  • 18 Bellini P, Lovison G. Square concordance tables in health data analysis. Rev St Appl 1988; 4: 443-58.
    PubMedSearch in Google Scholar
  • 19 O’Connel DL, Dobson AJ. General observer-agreement measurement on individual subjects. Biometrics 1984; 40: 973-83.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    Search in Google Scholar
  • 21 Dobson AJ. An Introduction to Statistical Modelling. London: Chapman and Hall; 1983
    Search in Google Scholar