title: Coding accuracy for Parkinson's disease hospital admissions: implications for healthcare planning in the UK.
abstract: OBJECTIVE
  Hospital Episode Statistics data are used for healthcare planning and hospital reimbursements. Reliability of these data is dependent on the accuracy of individual hospitals reporting Secondary Uses Service (SUS) which includes hospitalisation. The number and coding accuracy for Parkinson's disease hospital admissions at a tertiary centre in Birmingham was assessed.
  
  
  METHODS
  Retrospective, routine-data-based study.
  
  
  METHODS
  A retrospective electronic database search for all Parkinson's disease patients admitted to the tertiary hospital over a 4-year period (2009-2013) was performed on the SUS database using International Classification of Disease codes, and on the local inpatient electronic prescription database, Prescription and Information Communications System, using medication prescriptions. Capture-recapture methods were used to estimate the number of patients and admissions missed by both databases.
  
  
  RESULTS
  From the two databases, between July 2009 and June 2013, 1068 patients with Parkinson's disease accounted for 1999 admissions. During these admissions, the Parkinson's disease was coded as a primary or secondary diagnosis. Ninety-one percent of these admissions were recorded on the SUS database. Capture-recapture methods estimated that the number of Parkinson's disease patients admitted during this period was 1127 patients (95% confidence interval: 1107-1146). A supplementary search of both SUS and Prescription and Information Communications System was undertaken using the hospital numbers of these 1068 patients. This identified another 479 admissions. SUS database under-estimated Parkinson's disease admissions by 27% during the study period.
  
  
  CONCLUSIONS
  The accuracy of disease coding is critical for healthcare policy planning and must be improved. If the under-reporting of Parkinson's disease admissions on the SUS database is repeated nationally, expenditure on Parkinson's disease admissions in England is under-estimated by approximately £61 million per year.
authors.affiliation: College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK; University Hospital Birmingham Foundation Trust, Queen Elizabeth Hospital Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK. Electronic address: shammuzerengi@yahoo.com.
authors.forename: S
authors.initials: S
authors.lastname: Muzerengi
authors.affiliation: College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors.forename: C
authors.initials: C
authors.lastname: Rick
authors.affiliation: University Hospital Birmingham Foundation Trust, Queen Elizabeth Hospital Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK.
authors.forename: I
authors.initials: I
authors.lastname: Begaj
authors.affiliation: College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors.forename: N
authors.initials: N
authors.lastname: Ives
authors.affiliation: University Hospital Birmingham Foundation Trust, Queen Elizabeth Hospital Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK.
authors.forename: F
authors.initials: F
authors.lastname: Evison
authors.affiliation: College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors.forename: R L
authors.initials: RL
authors.lastname: Woolley
authors.affiliation: College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK; University Hospital Birmingham Foundation Trust, Queen Elizabeth Hospital Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK; Department of Neurology, Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Dudley Road, Birmingham, B18 7QH, UK.
authors.forename: C E
authors.initials: CE
authors.lastname: Clarke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059019:Clinical Coding; D016208:Databases, Factual; D005260:Female; D006285:Health Planning; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D010300:Parkinson Disease / Q000628:therapy*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D006113:United Kingdom
keywords: Clinical coding; Hospital Episode Statistics; Parkinson's disease; Service evaluation