Hospital discharge diagnostic and procedure codes for upper gastro-intestinal cancer: how accurate are they?

Stavrou, Efty; Pesa, Nicole; Pearson, Sallie‐Anne

doi:10.1186/1472-6963-12-331

Cited by 15 publications

(13 citation statements)

References 32 publications

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“…The study assessed chemotherapy effects in the population of direct interest to local policymakers and service providers. Stavrou, Pesa, & Pearson, 2012). Another explanation for the low proportion of women with comorbidities could be the relatively young age distribution of the sample, with a mean age of 52.5 years at diagnosis.…”

Section: Strengths and Limitationsmentioning

confidence: 52%

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Risk of emergency hospitalisation and survival outcomes following adjuvant chemotherapy for early breast cancer in New South Wales, Australia

et al. 2019

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Objective:To examine risk of emergency hospital admission and survival following adjuvant chemotherapy for early breast cancer.Methods: Linked data from New South Wales population-based and clinical cancer registries (2008)(2009)(2010)(2011)(2012), hospital admissions, official death records and pharmaceutical benefit claims. Women aged ≥18 years receiving adjuvant chemotherapy for early-stage operable breast cancer in NSW public hospitals were included. Odds ratios (OR) for emergency hospitalisation within 6 months following chemotherapy initiation were estimated using logistic regression and survival using Kaplan-Meier and Cox proportional hazards methods.Results: A total of 3,950 women were included and 30.6% were hospitalised. The most common principal diagnosis at admission was neutropenia (30.8%). Women receiving docetaxel/carboplatin/trastuzumab (TCH) and docetaxel/cyclophosphamide (TC) were the most frequently hospitalised. After adjustment for demographic and clinical factors, the increased risk of hospitalisation for TCH and TC remained compared with doxorubicin/cyclophosphamide 3-weekly (OR 1.71, 95% confidence interval [CI] 1.24-2.37 and OR 1.47, 95% CI 1.17-1.85 respectively). Five-year overall survival was similar for women who were (92.2%, 95% CI 90.7-93.8) and were not hospitalised (93.1%, 95% CI 92.1-94.1).Conclusion: Emergency hospitalisations following chemotherapy for early breast cancer were relatively common, especially following docetaxel-containing protocols.Further examination of reasons for admission is needed to inform actions to improve patient safety. K E Y W O R D Sadjuvant, antineoplastic agents, breast neoplasms, chemotherapy, drug-related side effects and adverse reactions, hospitalisation, survival

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Section: Strengths and Limitationsmentioning

confidence: 52%

“…Also a relatively Stavrou, Pesa, & Pearson, 2012). Also a relatively Stavrou, Pesa, & Pearson, 2012).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Risk of emergency hospitalisation and survival outcomes following adjuvant chemotherapy for early breast cancer in New South Wales, Australia

et al. 2019

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“…Quality enhancement in administrative datasets can be achieved through improvement in acquisition processes 47 and incorporation of information from other data repositories and resources. 26,[48][49][50][51] Recently, the observed very low false-positive rates in administrative datasets 24,26,49,52 prompted the use of internal data linkage and temporal accumulation of information as methods to measure and reduce discrepancies resulting from different data recording practices and rules. 25,36,53,54 Similarly, we combined patient-specific admission and ED presentation records from both sending and receiving hospitals to capture all transfers regardless of their pathways and local strategies in documentation.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of inter-hospital transfer information in Australian hospital administrative databases

Assareh¹,

Achat

Lévesque

2017

Health Informatics J

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Inter-hospital transfers improve care delivery for which sending and receiving hospitals both accountable for patient outcomes. We aim to measure accuracy in recorded patient transfer information (indication of transfer and hospital identifier) over 2 years across 121 acute hospitals in New South Wales, Australia. Accuracy rate for 127,406 transfer-out separations was 87 per cent, with a low variability across hospitals (10% differences); it was 65 per cent for 151,978 transfer-in admissions with a greater inter-hospital variation (36% differences). Accuracy rate varied by departure and arrival pathways; at receiving hospitals, it was lower for transfer-in admission via emergency department (incidence rate ratio = 0.52, 95% confidence interval: 0.51-0.53) versus direct admission. Transfer-out data were more accurate for transfers to smaller hospitals (incidence rate ratio = 1.06, 95% confidence interval: 1.03-1.08) or re-transfers (incidence rate ratio > 1.08). Incorporation of transfer data from sending and receiving hospitals at patient level in administrative datasets and standardisation of documentation across hospitals would enhance accuracy and support improved attribution of hospital performance measures.

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“…For the rare conditions of hepatitis and HIV, our study benefited from a large state-wide cohort, providing more reliable discrepancy rates (of 37% and 27%) compared to other reports (zero to 33%) limited by small sample size [ 17 , 18 , 38 , 39 ]. We found noticeably high inconsistencies in coding morbidities that are either life threating or can cause severe complications, as is the case for HIV, which is listed among the most important risk factors of mortality in risk adjustment methods [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Variation of Discrepancies in Recording Chronic Conditions in Australian Hospital Administrative Data

et al. 2016

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Diagnostic data routinely collected for hospital admitted patients and used for case-mix adjustment in care provider comparisons and reimbursement are prone to biases. We aim to measure discrepancies, variations and associated factors in recorded chronic morbidities for hospital admitted patients in New South Wales (NSW), Australia. Of all admissions between July 2010 and June 2014 in all NSW public and private acute hospitals, admissions with over 24 hours stay and one or more of the chronic conditions of diabetes, smoking, hepatitis, HIV, and hypertension were included. The incidence of a non-recorded chronic condition in an admission occurring after the first admission with a recorded chronic condition (index admission) was considered as a discrepancy. Poisson models were employed to (i) derive adjusted discrepancy incidence rates (IR) and rate ratios (IRR) accounting for patient, admission, comorbidity and hospital characteristics and (ii) quantify variation in rates among hospitals. The discrepancy incidence rate was highest for hypertension (51% of 262,664 admissions), followed by hepatitis (37% of 12,107), smoking (33% of 548,965), HIV (27% of 1500) and diabetes (19% of 228,687). Adjusted rates for all conditions declined over the four-year period; with the sharpest drop of over 80% for diabetes (47.7% in 2010 vs. 7.3% in 2014), and 20% to 55% for the other conditions. Discrepancies were more common in private hospitals and smaller public hospitals. Inter-hospital differences were responsible for 1% (HIV) to 9.4% (smoking) of variation in adjusted discrepancy incidences, with an increasing trend for diabetes and HIV. Chronic conditions are recorded inconsistently in hospital administrative datasets, and hospitals contribute to the discrepancies. Adjustment for patterns and stratification in risk adjustments; and furthermore longitudinal accumulation of clinical data at patient level, refinement of clinical coding systems and standardisation of comorbidity recording across hospitals would enhance accuracy of datasets and validity of case-mix adjustment.

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Hospital discharge diagnostic and procedure codes for upper gastro-intestinal cancer: how accurate are they?

Cited by 15 publications

References 32 publications

Risk of emergency hospitalisation and survival outcomes following adjuvant chemotherapy for early breast cancer in New South Wales, Australia

Risk of emergency hospitalisation and survival outcomes following adjuvant chemotherapy for early breast cancer in New South Wales, Australia

Accuracy of inter-hospital transfer information in Australian hospital administrative databases

Incidence and Variation of Discrepancies in Recording Chronic Conditions in Australian Hospital Administrative Data

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