Validation of ICD-10 codes for studying foreign body airway obstructions: A health administrative data cohort study

Dunne, Cody L; Cirone, Julia; McRae, Andrew D; Blanchard, Ian; Holroyd-Leduc, Jayna; Sauro, Khara

doi:10.1016/j.resplu.2023.100479

Cited by 1 publication

(2 citation statements)

References 17 publications

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“…Among the methods used to assess patient safety status, administrative data (including diagnosis codes) has commonly been used to detect the presence of various types of PSIs [ 1 – 4 ]. However, the comprehensive accuracy of this approach remains underexplored with most studies focusing solely on the accuracy of POA indicators for certain PSI categories [ 13 – 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Among the diverse methods used to identify patient safety incidents (PSIs), administrative data have been increasing use [ 1 – 4 ]. Administrative data such as claims and billing information are amassed through numerous channels during medical processes and stand out for their relative ease of use compared to other kinds of data or methods used to assess patient safety status [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Accuracy assessment of patient safety incident (PSI) codes and present-on-admission (POA) indicators: a cross-sectional analysis using the Patient Safety Incidents Inquiry (PSII) in Korea

Pyo,

Choi,

Jang

et al. 2024

BMC Health Serv Res

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Background Among the various methods used, administrative data collected for claims and billing purposes, such as diagnosis codes and present-on-admission (POA) indicators, can easily be employed to assess patient safety status. However, it is crucial that administrative data be accurate to generate valid estimates of adverse event (AE) occurrence. Thus, we aimed to evaluate the accuracy of diagnosis codes and POA indicators in patients with confirmed AEs in the hospital admission setting. Methods We analysed the diagnosis codes of 1,032 confirmed AE cases and 6,754 non-AE cases from the 2019 Patient Safety Incidents Inquiry, which was designed as a cross-sectional study, to determine their alignment with the Korean Patient Safety Incidents (PSIs) Code Classification System. The unit of analysis was the individual case rather than the patient, because two or more AEs may occur in one patient. We examined whether the primary and secondary diagnostic codes had PSIs codes matching the AE type and checked each PSI code for whether the POA indicator had an ‘N’ tag. We reviewed the presence of PSI codes in patients without identified AEs and calculated the correlation between the AE incidence rate and PSI code and POA indicator accuracy across 15 hospitals. Results Ninety (8.7%) of the AE cases had PSI codes with an ‘N’ tag on the POA indicator compared to 294 (4.4%) of the non-AE cases. Infection- (20.4%) and surgery/procedure-related AEs (13.6%) had relatively higher instances of correctly tagged PSI codes. We did not identify any PSI codes for diagnosis-related incidents. While we noted significant differences in AE incidence rates, PSI code accuracy, and POA indicator accuracy among the hospitals, the correlations between these variables were not statistically significant. Conclusion Currently, PSI codes and POA indicators in South Korea appear to have low validity. To use administrative data in medical quality improvement activities such as monitoring patient safety levels, improving the accuracy of administrative data should be a priority. Possible strategies include targeted education on PSI codes and POA indicators and introduction of new evaluation indicators regarding the accuracy of administrative data.

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