title: Discrepancy Between Identification of Early-Term Elective Deliveries by Manual Chart Review and Data Vendor.
abstract: Elective delivery from 37 to 39 weeks gestation (early-term deliveries) is a Joint Commission National Quality Measure, and hospitals report on early-term elective delivery rates through Outcome Research Yields Excellence (ORYX) vendors. The objective of this study was to compare early-term elective deliveries, identified through ORYX vendors with those identified through manual chart review, the traditional method of medical record review. We reviewed early-term labor inductions and cesarean deliveries at a single hospital from June 1, 2010 to May 31, 2012. Rates of early-term elective deliveries identified by the data vendor were compared to physician chart review. Overall, the rate of elective deliveries by ORYX was 3% compared to 2% by physician chart review (RR 1.51 [95% CI 1.12-2.03],P< .001). Of the 116 elective early-term deliveries identified by vendor and/or chart review, vendors classified significantly more inductions and cesareans as elective (P< .001) and missed nine elective deliveries. Of the 107 deliveries identified as elective by ORYX, 62 (57.9%) were verified by chart review, including 69.0% of cesareans and 36.1% of inductions. Findings from this study suggest substantial discrepancy between identification of early-term elective deliveries by data vendors and physician chart review, and indicate that vendor-derived data may overestimate the number of electively delivered patients.
authors.affiliation: Department of Obstetrics Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (KY, P-JST, MB, BK).
authors.forename: Kelly
authors.initials: K
authors.lastname: Yamasato
authors.affiliation: Department of Obstetrics Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (KY, P-JST, MB, BK).
authors.forename: Pai-Jong Stacy
authors.initials: PS
authors.lastname: Tsai
authors.affiliation: Department of Obstetrics Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (KY, P-JST, MB, BK).
authors.forename: Marguerite
authors.initials: M
authors.lastname: Bartholomew
authors.affiliation: Department of Obstetrics Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (KY, P-JST, MB, BK).
authors.forename: Marsha
authors.initials: M
authors.lastname: Durbin
authors.affiliation: Department of Obstetrics Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (KY, P-JST, MB, BK).
authors.forename: Chieko
authors.initials: C
authors.lastname: Kimata
authors.affiliation: Department of Obstetrics Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (KY, P-JST, MB, BK).
authors.forename: Bliss
authors.initials: B
authors.lastname: Kaneshiro
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006254:Hawaii; D006801:Humans; D007751:Labor, Induced / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: Cesarean Section; Joint Commission on Accreditation of Healthcare Organizations; Labor, induced; delivery, obstetric; elective surgical procedures