Accuracy of obstetric diagnoses and procedures in hospital discharge data

Department of Obstetrics and Gynecology, University of California, Davis, Davis, California, United States
American journal of obstetrics and gynecology (Impact Factor: 3.97). 05/2006; 194(4):992-1001. DOI: 10.1016/j.ajog.2005.08.058
Source: PubMed

ABSTRACT The objective of the study was to estimate the validity of obstetric procedures and diagnoses in California patient discharge data.
We randomly sampled 1611 deliveries from 52 of 267 California hospitals that performed more than 678 eligible deliveries in 1992 to 1993. We compared hospital-reported procedures and diagnoses against our recoding of the same records.
Cesarean, forceps, and vacuum delivery were accurately reported, with sensitivities and positive predictive values exceeding 90%. Episiotomy was underreported (70% sensitivity). Cesarean indications were reported with at least 60% sensitivity, except uterine inertia, herpes, and long labor. Among comorbidities, sensitivity exceeded 60% for chorioamnionitis, diabetes, premature labor, preeclampsia, and intrauterine death. Sensitivity was poor (less than 60%) for anemia, asthma, thyroid disorders, mental disorders, drug abuse, genitourinary infections, obesity, fibroids, excessive fetal growth, hypertension, premature rupture, polyhydramnios, and postdates.
The validity of hospital-reported obstetric procedures and diagnoses varies, with moderate to high accuracy for some codes but poor accuracy for others.

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    • "however, be improved by record linkage either over time and/or to other datasets. Table 2 Sensitivity of reporting in hospital discharge data compared to the gold standard of medical record review: comparison of our results to other studies of maternal medical conditions Condition or complication NSW data (Present study) Washington State data (Lydon-Rochelle et al. 2005) 7 Californian data (Yasmeen et al. 2006) "
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