The accuracy of hospital discharge coding for hemorrhagic stroke.
BACKGROUND
Hospital discharge data is used in monitoring stroke epidemiology, and ensuring adequate resource allocation to treatment programs. Previous studies have reported variable accuracy levels for such data. We present the first study assessing the accuracy of International Classification of Diseases 10th Edition (ICD-10) discharge coding for hemorrhagic stroke in England.


METHODS
We identified all patients with a primary diagnosis of intracerebral hemorrhage (ICH; ICD-10 code: I61.x) and subarachnoid hemorrhage (SAH; I60.x) admitted to the Newcastle upon Tyne Hospitals from 2002-2007. Positive predictive values (PPV) were calculated through validation with patient notes.


RESULTS
Hospital discharge coding identified 978 ICH and 1169 SAH admissions over the six years. The number of diagnoses verified by patient notes was excellent for both ICH (n = 938) and SAH (n = 1123), with a PPV of 95.9% for ICH (95% confidence interval, CI = 94.5-97.0%) and 96.1%for SAH (95% CI = 94.8-97.0%). The coding errors observed were largely expected, with different types of stroke miscoded as ICH and SAH.


CONCLUSIONS
The accuracy of ICD-10 hospital discharge coding for hemorrhagic stroke was excellent. However further research is needed to find ways to further improve its accuracy.
Kirkman
Matthew Anthony
MA
Department of Neurosurgery, Regional Neurosciences Centre, Newcastle General Hospital, Newcastle upon Tyne, NE4 6BE, United Kingdom. matthew.kirkman@gmail.com
Mahattanakul
Wattana
W
Gregson
Barbara A
BA
Mendelow
A David
AD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005568:Forms and Records Control; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000453:epidemiology; D055815:Young Adult