Coding for surgical audit.
A simple system of codes for operations, diagnoses and complications, developed specifically for computerized surgical audit, is described. This arose following a review of our established surgical audit in which problems in the retrieval of data from the database were identified. Evaluation of current methods of classification of surgical data highlighted the need for a dedicated coding system that was suitable for classifying surgical audit data, enabling rapid retrieval from large databases. After 2 years of use, the coding system has been found to fulfil the criteria of being sufficiently flexible and specific for computerized surgical audit, yet simple enough for medical staff to use.
Pettigrew
R A
RA
Department of Surgery, University of Otago, Dunedin, New Zealand.
van Rij
A M
AM
D003953:Diagnosis-Related Groups; D004018:Dictionaries, Medical as Topic; D001330:Electronic Data Processing / Q000379:methods*; D013502:General Surgery / Q000592:standards*; D006801:Humans; D008485:Medical Audit / Q000379:methods*; D010343:Patient Admission; D011183:Postoperative Complications / Q000145:classification; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000145:classification / Q000401:mortality; D009626:Terminology as Topic