title: [The role of the quality of hospital discharge records on the comparative evaluation of outcomes: the example of chronic obstructive pulmonary disease (COPD)].
abstract: OBJECTIVE
  To analyse the results of the regional comparative evaluation of the outcome "thirty days mortality after admission for reacutized Chronic obstructive pulmonary disease (COPD)" before and after a reabstract study.
  
  
  METHODS
  Reabstract study of clinical records included in the regional comparative evaluation.
  
  
  METHODS
  232 clinical records retrieved from Grassi Hospital archives (years 2006-2007) and reviewed by two physicians and one nurse specifically trained.
  
  
  METHODS
  Models performed before and after reabstract study for comparative evaluation of the outcome were compared. Blind coding of diagnosis and interventions/procedures was completed according to a standard grid consistent with regional guidelines for Hospital Discharge Record coding. Other information was registered, if present on discharge record: smoking habit, number of reacutizations occurred within previous year, use of oxigen and/or other therapies, pneumological visit at discharge.
  
  
  RESULTS
  The majority (94%) of reviewed cases were confirmed as being cases of COPD. A total of 168 cases (72%) have been identified as reacutized COPD coherent with enrolment criteria of regional program, 49 (21%) have been identified as COPD and only 15 cases (6%) resulted not affected by COPD. Results of the regional comparative model were substantially unchanged for Grassi hospital (RR =23 vs RR =24). Accurateness of clinical documentation resulted inadequate especially regarding information at discharge (50% missing information on smoking habit, 83% on previous year reacutizations, 22% on follow-up organization after discharge).
  
  
  CONCLUSIONS
  This study contributes to the debate on the role of administrative data on the comparative evaluation of health outcomes. Other relevant issues are to promote the collaboration among different health professionals working in the same hospital, and to increase the awareness of the importance of the quality of health and administrative data.
authors: UOC Programmazione, Sistema Informative ed Epidemiologia, ASL Roma D, Roma. valeria.fano@aslromad.it
authors: Valeria
authors: V
authors: Fano
authors: Mariangela
authors: M
authors: D'Ovidio
authors: Katiuscia
authors: K
authors: del Zio
authors: Davide
authors: D
authors: Renzi
authors: Daniela
authors: D
authors: Tariciotti
authors: Nera
authors: N
authors: Agabiti
authors: Lucia
authors: L
authors: Argenti
authors: Maria Sofia
authors: MS
authors: Cattaruzza
authors: Antonio
authors: A
authors: Fortino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records / Q000592:standards*; D008875:Middle Aged; D010351:Patient Discharge; D063868:Patient Outcome Assessment; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*