Underreporting of Congenital Heart Disease in Hospital Discharge Codes
Author Information
Author(s): Jason Chami, Calum Nicholson, Geoff Strange, David Baker, Rachael Cordina, David S. Celermajer
Primary Institution: Royal Prince Alfred Hospital
Hypothesis
Congenital heart diseases might be underreported and/or inaccurately reported in hospital discharge coding summaries.
Conclusion
Hospital discharge coding dramatically underreports congenital heart disease, especially for patients with moderate and severe lesions.
Supporting Evidence
- Only 26% of discharge coding summaries contained any diagnosis of congenital heart disease.
- Patients with simple lesions were coded best, while those with moderate and complex lesions were coded worst.
- Admissions under cardiovascular specialties were twice as likely to have a coded diagnosis of congenital heart disease.
Takeaway
Doctors often forget to write down heart problems when patients leave the hospital, especially if the problems are complicated. This means we might not know how many people really have these heart issues.
Methodology
The study analyzed discharge coding summaries for 257 admissions of adults with congenital heart disease over three years and compared them to a verified database.
Potential Biases
Potential bias due to the lack of specific training for CHD coding and the variability in documentation quality by junior doctors.
Limitations
The study only examined discharge coding summaries from the past three years, limiting the understanding of CHD coding across patients' lifetimes.
Participant Demographics
Adults with congenital heart disease admitted to Royal Prince Alfred Hospital.
Statistical Information
P-Value
0.006
Statistical Significance
p=0.006
Digital Object Identifier (DOI)
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