Hospital discharge data can be used for monitoring procedures and intensive care related to severe maternal morbidity

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• 作者：Anne A. Chantry^a ; ^b ; ^{anne.chantry@inserm.fr"" rel=""nofollow} ; Catherine Deneux-Tharaux^a ; ^b ; Christine Cans^c ; Anne Ego^a ; ^d ; Catherine Quantin^e ; ^f ; Marie-H&#xe9 ; l&#xe8 ; ne Bouvier-Colle^a ; ^b ; GRACE study group¹
• 关键词：Severe maternal morbidity ; Hospital discharge data ; Validity ; Sensitivity ; Positive predictive value ; Medical records
• 刊名：Journal of Clinical Epidemiology
• 出版年：2011
• 出版时间：September 2011
• 年：2011
• 卷：64
• 期：9
• 页码：1014-1022
• 全文大小：404 K

文摘

Objective

To estimate the accuracy and reliability of the reporting of diagnoses and procedures related to severe acute maternal morbidity in French hospital discharge data.

Study Design and Setting

The study, conducted in four French tertiary teaching hospitals, covered the years 2006 and 2007 and 30,607 deliveries. We identified severe maternal morbid events—eclampsia, pulmonary embolism, procedures related to postpartum hemorrhages, and intensive care—in administrative hospital discharge data and medical records and compared their recording. Information from medical records was the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value of the hospital discharge data for these events were calculated. False positives and false negatives were examined to identify the reasons for misrecorded information.

Results

The PPV of the hospital discharge data was 20 % for eclampsia. For procedures related to postpartum hemorrhages, the PPVs were high, but sensitivities were lower; however, 95 % of recording errors could be corrected. All indicators for intensive care exceeded 98 % .

Conclusion

Intensive care and procedures seem reliably reported in the hospital administrative database, which, therefore, can be used to monitor them. Using these data for monitoring diagnoses will require a greater investment by clinicians in the accuracy of their reporting.