Generic obstetric database systems are unreliable for reporting the hypertensive disorders of pregnancy.
BACKGROUND
Obstetric outcome data can be accessed by a variety of different methods in New South Wales, Australia, including Diagnosis-Related Group (DRG) summaries and the Midwives Data Collection (MDC). The accuracy of the reporting of the obstetric complications encompassed by the hypertensive disorders of pregnancy (HDP) has been doubted owing to the inconsistency and confusing coding categories available in both coding systems.


OBJECTIVE
To test that there would be no disagreement in coding between DRG coding, MDC coding and a disorder-specific database.


METHODS
A prospective disorder-specific database, namely the Hypertensive Disorders of Pregnancy Database (HDPDB), was maintained for 6 months and diagnoses were compared with the DRG and MDC coding systems. Medical records of all women (n = 230) who received a HDP coding during this period were examined and recoded using the Australasian Society for the Study of Hypertension in Pregnancy diagnostic groupings. The HDPDB was the gold standard for the comparison of coding.


RESULTS
Significant coding errors were found in both systems available. Sixty-four percent (P < 0.001) of medical records were incorrectly coded in the DRG coding system and 56% (P < 0.001) were incorrectly coded in the MDC.


CONCLUSIONS
Current database systems are unreliable for recording maternal medical conditions, such as hypertension, and accuracy can only be assured with the use of a disorder-specific database, such as the HDPDB.
Thornton
Charlene
C
Hypertensive Disorders of Pregnancy Unit, Royal Prince Alfred Hospital, New South Wales, Australia. charlene.thornton@email.cs.nsw.gov.au
Makris
Angela
A
Ogle
Robert
R
Hennessy
Annemarie
A
D003627:Data Interpretation, Statistical; D019992:Databases as Topic / Q000592:standards*; D003953:Diagnosis-Related Groups; D005260:Female; D005568:Forms and Records Control; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D038801:International Classification of Diseases; D009517:New South Wales; D009774:Obstetrics / Q000592:standards / Q000639:trends; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity