Deriving ICD-10 Codes for Patient Safety Indicators for Large-scale Surveillance Using Administrative Hospital Data

Danielle A. Southern, Bernard Burnand, Saskia E. Droesler, Ward Flemons, Alan J. Forster, Yana Gurevich, James Harrison, Hude Quan, Harold A. Pincus, Patrick S Romano, Vijaya Sundararajan, Nenad Kostanjsek, William A. Ghali

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

BACKGROUND:: Existing administrative data patient safety indicators (PSIs) have been limited by uncertainty around the timing of onset of included diagnoses. OBJECTIVE:: We undertook de novo PSI development through a data-driven approach that drew upon “diagnosis timing” information available in some countries’ administrative hospital data. RESEARCH DESIGN:: Administrative database analysis and modified Delphi rating process. SUBJECTS:: All hospitalized adults in Canada in 2009. MEASURES:: We queried all hospitalizations for ICD-10-CA diagnosis codes arising during hospital stay. We then undertook a modified Delphi panel process to rate the extent to which each of the identified diagnoses has a potential link to suboptimal quality of care. We grouped the identified quality/safety-related diagnoses into relevant clinical categories. Lastly, we queried Alberta hospital discharge data to assess the frequency of the newly defined PSI events. RESULTS:: Among 2,416,413 national hospitalizations, we found 2590 unique ICD-10-CA codes flagged as having arisen after admission. Seven panelists evaluated these in a 2-round review process, and identified a listing of 640 ICD-10-CA diagnosis codes judged to be linked to suboptimal quality of care and thus appropriate for inclusion in PSIs. These were then grouped by patient safety experts into 18 clinically relevant PSI categories. We then analyzed data on 2,381,652 Alberta hospital discharges from 2005 through 2012, and found that 134,299 (5.2%) hospitalizations had at least 1 PSI diagnosis. CONCLUSION:: The resulting work creates a foundation for a new set of PSIs for routine large-scale surveillance of hospital and health system performance.

Original languageEnglish (US)
JournalMedical Care
DOIs
StateAccepted/In press - Sep 15 2016

Fingerprint

International Classification of Diseases
Patient Safety
Alberta
Hospitalization
Quality of Health Care
Uncertainty
Canada
Length of Stay
Databases
Safety
Health

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health

Cite this

Southern, D. A., Burnand, B., Droesler, S. E., Flemons, W., Forster, A. J., Gurevich, Y., ... Ghali, W. A. (Accepted/In press). Deriving ICD-10 Codes for Patient Safety Indicators for Large-scale Surveillance Using Administrative Hospital Data. Medical Care. https://doi.org/10.1097/MLR.0000000000000649

Deriving ICD-10 Codes for Patient Safety Indicators for Large-scale Surveillance Using Administrative Hospital Data. / Southern, Danielle A.; Burnand, Bernard; Droesler, Saskia E.; Flemons, Ward; Forster, Alan J.; Gurevich, Yana; Harrison, James; Quan, Hude; Pincus, Harold A.; Romano, Patrick S; Sundararajan, Vijaya; Kostanjsek, Nenad; Ghali, William A.

In: Medical Care, 15.09.2016.

Research output: Contribution to journalArticle

Southern, DA, Burnand, B, Droesler, SE, Flemons, W, Forster, AJ, Gurevich, Y, Harrison, J, Quan, H, Pincus, HA, Romano, PS, Sundararajan, V, Kostanjsek, N & Ghali, WA 2016, 'Deriving ICD-10 Codes for Patient Safety Indicators for Large-scale Surveillance Using Administrative Hospital Data', Medical Care. https://doi.org/10.1097/MLR.0000000000000649
Southern, Danielle A. ; Burnand, Bernard ; Droesler, Saskia E. ; Flemons, Ward ; Forster, Alan J. ; Gurevich, Yana ; Harrison, James ; Quan, Hude ; Pincus, Harold A. ; Romano, Patrick S ; Sundararajan, Vijaya ; Kostanjsek, Nenad ; Ghali, William A. / Deriving ICD-10 Codes for Patient Safety Indicators for Large-scale Surveillance Using Administrative Hospital Data. In: Medical Care. 2016.
@article{b8caf5e09b0b42e686598c7cbc185e92,
title = "Deriving ICD-10 Codes for Patient Safety Indicators for Large-scale Surveillance Using Administrative Hospital Data",
abstract = "BACKGROUND:: Existing administrative data patient safety indicators (PSIs) have been limited by uncertainty around the timing of onset of included diagnoses. OBJECTIVE:: We undertook de novo PSI development through a data-driven approach that drew upon “diagnosis timing” information available in some countries’ administrative hospital data. RESEARCH DESIGN:: Administrative database analysis and modified Delphi rating process. SUBJECTS:: All hospitalized adults in Canada in 2009. MEASURES:: We queried all hospitalizations for ICD-10-CA diagnosis codes arising during hospital stay. We then undertook a modified Delphi panel process to rate the extent to which each of the identified diagnoses has a potential link to suboptimal quality of care. We grouped the identified quality/safety-related diagnoses into relevant clinical categories. Lastly, we queried Alberta hospital discharge data to assess the frequency of the newly defined PSI events. RESULTS:: Among 2,416,413 national hospitalizations, we found 2590 unique ICD-10-CA codes flagged as having arisen after admission. Seven panelists evaluated these in a 2-round review process, and identified a listing of 640 ICD-10-CA diagnosis codes judged to be linked to suboptimal quality of care and thus appropriate for inclusion in PSIs. These were then grouped by patient safety experts into 18 clinically relevant PSI categories. We then analyzed data on 2,381,652 Alberta hospital discharges from 2005 through 2012, and found that 134,299 (5.2{\%}) hospitalizations had at least 1 PSI diagnosis. CONCLUSION:: The resulting work creates a foundation for a new set of PSIs for routine large-scale surveillance of hospital and health system performance.",
author = "Southern, {Danielle A.} and Bernard Burnand and Droesler, {Saskia E.} and Ward Flemons and Forster, {Alan J.} and Yana Gurevich and James Harrison and Hude Quan and Pincus, {Harold A.} and Romano, {Patrick S} and Vijaya Sundararajan and Nenad Kostanjsek and Ghali, {William A.}",
year = "2016",
month = "9",
day = "15",
doi = "10.1097/MLR.0000000000000649",
language = "English (US)",
journal = "Medical Care",
issn = "0025-7079",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Deriving ICD-10 Codes for Patient Safety Indicators for Large-scale Surveillance Using Administrative Hospital Data

AU - Southern, Danielle A.

AU - Burnand, Bernard

AU - Droesler, Saskia E.

AU - Flemons, Ward

AU - Forster, Alan J.

AU - Gurevich, Yana

AU - Harrison, James

AU - Quan, Hude

AU - Pincus, Harold A.

AU - Romano, Patrick S

AU - Sundararajan, Vijaya

AU - Kostanjsek, Nenad

AU - Ghali, William A.

PY - 2016/9/15

Y1 - 2016/9/15

N2 - BACKGROUND:: Existing administrative data patient safety indicators (PSIs) have been limited by uncertainty around the timing of onset of included diagnoses. OBJECTIVE:: We undertook de novo PSI development through a data-driven approach that drew upon “diagnosis timing” information available in some countries’ administrative hospital data. RESEARCH DESIGN:: Administrative database analysis and modified Delphi rating process. SUBJECTS:: All hospitalized adults in Canada in 2009. MEASURES:: We queried all hospitalizations for ICD-10-CA diagnosis codes arising during hospital stay. We then undertook a modified Delphi panel process to rate the extent to which each of the identified diagnoses has a potential link to suboptimal quality of care. We grouped the identified quality/safety-related diagnoses into relevant clinical categories. Lastly, we queried Alberta hospital discharge data to assess the frequency of the newly defined PSI events. RESULTS:: Among 2,416,413 national hospitalizations, we found 2590 unique ICD-10-CA codes flagged as having arisen after admission. Seven panelists evaluated these in a 2-round review process, and identified a listing of 640 ICD-10-CA diagnosis codes judged to be linked to suboptimal quality of care and thus appropriate for inclusion in PSIs. These were then grouped by patient safety experts into 18 clinically relevant PSI categories. We then analyzed data on 2,381,652 Alberta hospital discharges from 2005 through 2012, and found that 134,299 (5.2%) hospitalizations had at least 1 PSI diagnosis. CONCLUSION:: The resulting work creates a foundation for a new set of PSIs for routine large-scale surveillance of hospital and health system performance.

AB - BACKGROUND:: Existing administrative data patient safety indicators (PSIs) have been limited by uncertainty around the timing of onset of included diagnoses. OBJECTIVE:: We undertook de novo PSI development through a data-driven approach that drew upon “diagnosis timing” information available in some countries’ administrative hospital data. RESEARCH DESIGN:: Administrative database analysis and modified Delphi rating process. SUBJECTS:: All hospitalized adults in Canada in 2009. MEASURES:: We queried all hospitalizations for ICD-10-CA diagnosis codes arising during hospital stay. We then undertook a modified Delphi panel process to rate the extent to which each of the identified diagnoses has a potential link to suboptimal quality of care. We grouped the identified quality/safety-related diagnoses into relevant clinical categories. Lastly, we queried Alberta hospital discharge data to assess the frequency of the newly defined PSI events. RESULTS:: Among 2,416,413 national hospitalizations, we found 2590 unique ICD-10-CA codes flagged as having arisen after admission. Seven panelists evaluated these in a 2-round review process, and identified a listing of 640 ICD-10-CA diagnosis codes judged to be linked to suboptimal quality of care and thus appropriate for inclusion in PSIs. These were then grouped by patient safety experts into 18 clinically relevant PSI categories. We then analyzed data on 2,381,652 Alberta hospital discharges from 2005 through 2012, and found that 134,299 (5.2%) hospitalizations had at least 1 PSI diagnosis. CONCLUSION:: The resulting work creates a foundation for a new set of PSIs for routine large-scale surveillance of hospital and health system performance.

UR - http://www.scopus.com/inward/record.url?scp=84987905635&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84987905635&partnerID=8YFLogxK

U2 - 10.1097/MLR.0000000000000649

DO - 10.1097/MLR.0000000000000649

M3 - Article

JO - Medical Care

JF - Medical Care

SN - 0025-7079

ER -