Clinical Investigations: Outcomes, Health Policy, and Managed CareA multicenter study of the coding accuracy of hospital discharge administrative data for patients admitted to cardiac care units in Ontario☆,☆☆,★,★★
Section snippets
Data sources
Data on each patient's diagnosis were obtained from 2 sources: the Fastrak II acute coronary syndromes registry and the CIHI hospital discharge abstracts database. The Fastrak II acute coronary syndromes database is a prospective clinical registry at a number of hospitals across Canada, including 58 hospitals from Ontario. In the CCU phase of the registry, data are gathered from consecutive patients admitted to the CCU in participating hospitals by the nurse looking after the patient in the CCU
Results
There were 61,688 eligible Fastrak II records for patients admitted between January 1, 1996, and March 1, 2000. Of these, 59,116 (95.8%) were linked to a CIHI discharge abstract. The Fastrak II discharge diagnosis was absent for 300 of these records (0.5%), resulting in a final cohort of 58,816 patients. Of the 59,116 patients who were linked to the CIHI database, 87.9% had an exact match on patient date of birth, sex, date of admission, and admitting institution. A further 6.6% of patients had
Discussion
Hospital discharge abstract databases are increasingly being used in health services research. However, it is important that the coding of cardiac diagnoses in these databases be validated. Our study represents one of the largest validation studies of the administrative databases ever undertaken. We linked prospective clinical registry data on 58,816 patients admitted to 58 CCUs in Ontario to hospital discharge abstract data. We examined the accuracy of the coding of AMI, arrhythmia, congestive
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Supported in part by an operating grant from the Canadian Institutes of Health Research (CIHR), and in part by a Canada Research Chair in Health Services Research, in part by the Ontario Ministry of Health and Long Term Care, and in part by Hoffmann-La Roche, Canada.
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The results and conclusions are those of the authors and should not be attributed to any of the sponsoring organizations.
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Reprint requests: Peter Austin, PhD, Institute for Clinical Evaluative Sciences, G-160, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5 Canada.
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E-mail: [email protected]