Document Detail


Validation of Hospital Administrative Dataset for adverse event screening.
MedLine Citation:
PMID:  20427309     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To assess whether the Belgian Hospital Discharge Dataset (B-HDDS) is a valid source for the detection of adverse events in acute hospitals.
DESIGN, SETTING AND PARTICIPANTS: Retrospective review of 1515 patient records in eight acute Belgian hospitals for the year 2005.
MAIN OUTCOME MEASURES: Predictive value of the B-HDDS and medical record reviews and degree of correspondence between the B-HDDS and medical record reviews for five indicators: pressure ulcer, postoperative pulmonary embolism or deep vein thrombosis, postoperative sepsis, ventilator-associated pneumonia and postoperative wound infection.
RESULTS: Postoperative wound infection received the highest positive predictive value (62.3%), whereas postoperative sepsis and ventilator-associated pneumonia were rated as only 44.2% and 29.9% respectively. Excluding present on admission from the screening substantially decreased the positive predictive value of pressure ulcer from 74.5% to 54.3%, as pressure ulcers present on admission were responsible for more B-HDDS-medical record mismatches than any other indicator. Over half (56.8%) of false-positive cases for postoperative sepsis were due to a lack of specificity of the ICD-9-CM code, whereas in 58.6% of false-positive cases for ventilator-associated pneumonia, clinical criteria appeared to be too stringent.
CONCLUSIONS: The B-HDDS has the potential to accurately detect some but not all adverse events. Adding a code 'present on admission' and improving the ICD-9-CM codes might already partially improve the correspondence between the B-HDDS and the medical record review.
Authors:
Sandra Verelst; Jessica Jacques; Koen Van den Heede; Pierre Gillet; Philippe Kolh; Arthur Vleugels; Walter Sermeus
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-04-27
Journal Detail:
Title:  Quality & safety in health care     Volume:  19     ISSN:  1475-3901     ISO Abbreviation:  Qual Saf Health Care     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136980     Medline TA:  Qual Saf Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  e25     Citation Subset:  H    
Affiliation:
Center for Health Services and Nursing Research, University Hospital of Liège, Liège, Belgium.
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