Can administrative data be used to ascertain clinically significant postoperative complications?

Patrick S Romano, Michael E. Schembri, Julie A. Rainwater

Research output: Contribution to journalArticle

81 Scopus citations

Abstract

The purpose of this study is to assess whether postoperative complications can be ascertained using administrative data. We randomly sampled 991 adults who underwent elective open diskectomies at 30 nonfederal acute care hospitals in California. Postoperative complications were specified by reviewing medical literature and by consulting clinical experts. We compared hospital-reported ICD-9-CM data and independently receded ICD-9-CM data with complications abstracted by clinicians using detailed criteria. Receded ICD-9-CM data were more likely than hospital-reported ICD-9-CM data to capture true complications, when they occurred, but they also mislabeled more patients who never experienced clinically significant complications. This finding was most evident for mild or ambiguous complications, such as atelectasis, posthemorrhagic anemia, and hypotension. Overall, recoded ICD-9-CM data captured 47% and 56% of all mild and severe complications, respectively, whereas hospitalreported ICD-9-CM data captured only 37% and 44%, respectively, of all mild and severe complications. These findings raise questions about the validity of using administrative data to ascertain postoperative complications, even if coders are carefully hired, trained, and supervised. ICD-9-CM complication codes are more promising as a tool to help providers identify their own adverse outcomes than as a tool for comparing performance.

Original languageEnglish (US)
Pages (from-to)145-154
Number of pages10
JournalAmerican Journal of Medical Quality
Volume17
Issue number4
StatePublished - Jul 2002

Keywords

  • Administrative data
  • Complications
  • Hospital outcomes
  • Performance measurement
  • Quality measurement
  • Quality of care

ASJC Scopus subject areas

  • Health Policy
  • Nursing(all)

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