[A retrospective study to an evaluation of the quality of Uniform Hospital Discharge Data Set regarding discharge with death of the patient attributed to a Diagnosis Related Group with a low Relative Weight; retrospective study in some hospitals in Rome [corrected]].
Aim of the present study is to evaluate the quality of medical record and Uniform Hospital Discharge Data Set (UHDDS), regarding admissions with death of the patient assigned to a Diagnosis Related Group (DRG) with a Relative Weight (RW) less than 1; the authors suggest that these admissions involve a more expensive hospital treatment if compared to admissions with favorable outcome and, therefore, the attribution of a DRG with RW more than 1 might be ascribed to an incorrect compilation of UHDDS. The admissions with the death of the patient, carried out between July 2002 and December 2002, in 11 different Rome hospitals located within the territory of two Local Health Units, have been split into 2 groups: admissions assigned to a DRG with RW less than 1 (group 1) and more than 1 (group 2). Afterward, two doctors of the Regional System of External Controls have required and examined the medical records of the group 1 (n= 57) using an evaluating format to verify the accuracy of UHDDS information. In the 91.0% (n=51) of the cases the UHDDS coding have been considered inadequate. In the 96.2% of the cases (n=49) the principal diagnosis has not been correctly coded while, in the 69.2% of the cases (n=36), at least one of the secondary diagnosis has been incorrectly reported. Medium RW rose from 0,7893 to 1,4354 after controllers' review and assignment of the new DRG. The results have confirmed the initial hypothesis and pointed out how an incorrect compilation of the UHDDS might compromise its validity under a statistic and epidemiologic point of view and produce significant repercussions under the economic one.
Rosati
Enrico
E
Sistema Regionale dei Controlli Esterni dell'Attività Ospedaliera, Agenzia di Sanità Pubblica della Regione Lazio.
Polistena
Alberto
A
Maurici
Massimo
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003953:Diagnosis-Related Groups / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006753:Hospital Records / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012384:Rome