صحت کدگذاری علت زمینه‌ای مرگ در بیمارستان‌های آموزشی بندرعباس

نوع مقاله : مقاله پژوهشی

نویسندگان
محمدحسین حیوی حقیقی 1
محمد دهقانی 2
فرید خرمی 2
جهان پور علی پور 3
1 مربی، مدارک پزشکی، دانشکده‌ی پیراپزشکی، دانشگاه علوم پزشکی هرمزگان، بندرعباس و دانشجوی دکتری، مدیریت اطلاعات بهداشتی، دانشکده‌ی پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران
2 مربی، مدارک پزشکی، دانشکده‌ی پیراپزشکی، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران
3 مربی، گروه فن‌آوری اطلاعات سلامت، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران و دانشجوی دکترای مدیریت اطلاعات بهداشتی، دانشگاه علوم پزشکی تهران، تهران، ایران
چکیده
مقدمه: صحت کدگذاری علت زمینه‌ای مرگ با اطلاعات گواهی فوت و تفسیر قوانین کدگذاری علل مرگ توسط کدگذاران ارتباط دارد. هدف این مطالعه، تعیین صحت کدگذاری علت زمینه‌ای مرگ در بیمارستان‌های آموزشی دانشگاه علوم پزشکی هرمزگان بود. روش بررسی: این پژوهش توصیفی- مقطعی در شش ماهه‌ی اول سال 1390 انجام شد. جامعه‌ی پژوهش شامل گواهی فوت کلیه‌ی متوفیان بیمارستان‌های آموزشی شهید محمدی (345 مورد) و کودکان (59 مورد) بود. ابتدا اطلاعات گواهی فوت بر روی فرم‌های جداگانه ثبت شد و دستیاران هر بخش، نسبت به تعیین توالی‌ها اقدام نمودند. سپس پژوهشگر، نسبت به کدگذاری مجدد و مقایسه با کدهای کدگذاران اقدام نمود. داده‌ها در نرم‌افزار SPSS ثبت و از طریق آمار توصیفی و آزمون Chi-square تحلیل شد. یافته‌ها: صحت کدگذاری در بیمارستان شهید محمدی 7/51 درصد، در بیمارستان کودکان 0/54 درصد و در مجموع، 1/52 درصد بود. صحت کدگذاری با فصول ICD (International statistical classification of diseases)، تعداد خطوط و زبان تکمیل گواهی فوت رابطه‌ی معنی‌داری داشت. بهترین وضعیت کدگذاری متعلق به فصول بیماری‌های دستگاه تناسلی- ادراری (5/87 درصد) و نئوپلاسم‌ها (4/96 درصد) و بدترین وضعیت نیز متعلق به فصول علل خارجی (4/21 درصد) و بیماری‌های غدد درون‌ریز، تغذیه و متابولیک (6/27 درصد) بود. بیشترین کاربرد (0/36 درصد) و بهترین وضعیت کدگذاری (0/65 درصد صحت) متعلق به قانون عمومی و بیشترین خطا (0/85 درصد) متعلق به قانون 3 بود. قوانین کدگذاری نئوپلاسم‌ها به میزان (7/65 درصد) رعایت شده بود. نتیجه‌گیری: کدگذاری علل مرگ در بیمارستان‌های مورد مطالعه وضعیت مطلوبی نداشت. آموزش پزشکان (درباره‌ی نحوه‌ی تکمیل گواهی فوت) و کدگذاران (درباره‌ی قوانین موجود برای انتخاب و کدگذاری علت زمینه‌ای مرگ) ضروری به نظر می‌رسد. واژه‌های کلیدی: علت زمینه‌ای مرگ؛ گواهی فوت؛ کدگذاری؛ طبقه‌بندی بین‌المللی بیماری‌ها- ویرایش دهم

کلیدواژه‌ها

عنوان مقاله English

Accuracy Rate of Underlying Cause of Death Coding in Educational Hospitals of Bandar Abbas, Iran

نویسندگان English

Mohammad Hossein Hayavi Haghighi 1
Mohammad Dehghani 2
Farid Khorrami 2
Jahanpour Alipour 3
1 Lecturer, Medical Records, School of Paramedicine, Hormozgan University of Medical Sciences, Hormozgan, AND PhD Candidate, Health Information Management, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Lecturer, Medical Records, School of Paramedicine, Hormozgan University of Medical Sciences, Hormozgan, Iran
3 Lecturer, Health Information Technology, School of Paramedical, Zahedan University of Medical Sciences, Zahedan AND PhD Student, Health Information Management, Tehran University of Medical Sciences, Tehran, Iran
چکیده English

Introduction: Coding underlying cause of death is associated with both written information on death certificate and interpretation of rules about coding cause of death by coder. This study aimed to review the cause of death coding accuracy in Hormozgan University of Medical Sciences (Hormozgan, Iran). Methods: This was a descriptive cross-sectional study which was performed in 2010-2011 for six months. The study population included the death certificates of all the deceased in Shahid Mohammadi Educational Hospital (n = 345) and Pediatrics Educational Hospital (n = 59). First, information of death certificates was written on new forms. Then, the residents of the clinical wards determined the sequences and then the researcher took action for recoding death certificates and comparing his codes by original coders. Data were analyzed by descriptive statistics and chi-square test. Results: Coding accuracy rate in Shahid Mohammadi Hospital, Pediatrics Hospital and in total were 51.7%, 54% and 52.1%, respectively. Coding accuracy had a statistically significant association with International Classification of Diseases Tenth Edition (ICD-10) chapters, number of lines and languages used for completing death certificates. The best status of coding was in chapters of genitourinary system diseases (87.5 percent) and neoplasms (69.4%). The worst condition was in chapters of external causes (21.4%) and endocrine, nutritional and metabolic diseases. The most application (36%) and the best coding status (65% accuracy) belonged to general rule. Rule 3 was the most erroneous (85%) and neoplasms coding rules had been observed at rate 65.7%. Conclusion: Coding cause of death in these hospitals had not desirable status and education is essential for both physicians (regarding how to complete the death certificate) and coders (about rules of selecting and coding underlying cause of death). Keywords: Underlying Cause of Death; Death Certificate; Coding; International Classification of Diseases 10th Edition

  1. - Myers K, Farquhar D. Improving the accuracy of death certifications. CMAJ 1998; 158(10): 1317-1323.
  2. - Goldacre MJ, Roberts SE, Griffith M: Multiple-cause coding of death from myocardial infarction: population-based study of trends in death certificate data. J Public Health Med 2003, 25(1): 69-71
  3. - Akbarzade bagheban A R, Masarrat E, Hemmati M. Concord rate of existed diagnoses in hospital record and cause of death entered in death certification in loghman e hakim hospital in 2005. Specialty journal of iran epidemiology 2007: 3(1,2): 39-46 [Persian]
  4. - Mehdipour Y. coding causes of death by ICD-10. Tehran, Jafari. 2008: 6-7 [Persian]
  5. - Schade B: Reliability and validity of the classification of death in general practice. Scand J Prim Health Care 1987, 5(2):109-112.
  6. - Lu T, Hsu P, Bjorkenstam C, Anderson R. Certifying diabetes-related cause-of-death: a comparison of inappropriate certification statements in Sweden, Taiwan and the USA. Diabetologia 2006; 49(12): 2878–2881
  7. - World Health Organization. ICD-10 2003 version (2nd ed) vol 2—instruction manual. Available at. http://www. who.int/entity/classifications/icd/ICD-10_2nd_ed_volume2.pdf. Accessed 21 December 2011
  8. - Villar J, perez-mendez L. Evaluating an educational intervention to improve the accuracy of death certification among trainees from various specialties. BMC Health Serv Res 2007; 15;7:183
  9. - Geoffrey R. Swain G, Ward G, Hartlaub P. Death Certificates: Let’s Get It Right. Am Fam Physician 2005; 71(4): 652-656.
  10. - Start R, Bury J, Strachan A, Cross S, Underwood J. Evaluating the reliability of causes of death in published clinical research. Br Med 1997; 314(7076): 271-272
  11. - Moy C, Albert D, Diener-West M, McCaffrey L, Scully R, Willson J. Cause-Specific Mortality Coding: Methods in the Collaborative Ocular Melanoma Study COMS Report No. 14. Control Clin Trials. 2001 Jun;22(3):248-62
  12. - MacIntyre CR, Ackland MJ, Chandraraj EJ, Pilla JE. Accuracy of ICD-9-CM codes in hospital morbidity data, Victoria: implications for public health research. Aust N Z J Public Health 1997;21(5):477-82.
  13. - Medical Record Manual: A Guide for Developing Countries. WHO; 2002، Revised and Updated 2006: 43-6.
  14. - Shorbaji NA. Health and Medical Informatics: Technical Paper. WHO: Cario, Egypt: 2001: 6-8.
  15. - Franca E, de Abreu D, Rao C, Lopez A. Evaluation of cause of-death statistics in Brazil 2002–2004. Int J Epidemiol 2008; 37(4): 891–901.
  16. - Anderson R, Rosenberg H. Disease classification: measuring the effect of the tenth revision of the International classification of diseases on cause-of-death data in the United States. Stat Med 2003;22(9):1551–1570.
  17. - Schelhase T, Weber S. Mortality statistics in Germany. Problems and perspectives. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50(7):969–976
  18. - Himmanshu P, Bose N, Shah R, Chaudhury N, Phatak A. Educational intervention to improve death certification at a teaching hospital. The National Medical Journal Of India 2009; 22(6):317-319
  19. - Mahapatra P, Chalapatirao P. Cause of death reporting systems in India: A performance analysis. The National Medical Journal Of India India 2001; 14(3): 154-162
  20. - Farzandipour M, shiekhtaheri A. Evaluation of Factors Influencing Accuracy of Principal Procedure Coding Based on ICD-9-CM: An Iranian Study. Perspect Health Inf Manag. 2009; 6: 5
  21. - Ahmadi M, alipour J. Adherance to quality elements for coding of diagnoses and procedures. Hakim Research Journal 2009; 12 (1): 11- 18. [Persian]
  22. - Jahanbakhsh M, Saghaeyannejad Isfahani S. Survey of coder's knowledge about coding guidelines in hospitals in Isfahan. Health Information Management 2010; 7(1): 76-82. [Persian]
  23. - Shokrizade arani L, Karami M. Physicians' and Clinical Coders' Knowledge about Cause of Death Rules for Death Certification in Hospitals Affiliated to Kashan University of Medical Sciences. Iranian Journal of Medical Education 2010; 10(1): 19-25. [Persian]
  24. - Harteloh P, Bruin K, Kardaun J. The reliability of cause-of-death coding in The Netherlands. Eur J Epidemiol 2010; 25(8):531–538.
  25. - Tsung H, Meng CL, Ming CC. Accuracy of cause-of-death coding in Taiwan: types of miscoding and effects on mortality statistics. International Journal of Epidemiology 2000; 29(2): 336- 343
  26. - Winkler V, Ott J, Becher H. Reliability of coding causes of death with ICD-10 in Germany. Int J Public Health 2010; 55(1):43–48.
  27. - Rooney C, Griffiths C, Cook L. The implementation of ICD-10 for cause of death coding – some preliminary results from the bridge coding study. Health Statistics Quarterly SPr 2002; 13(08): 31-41
  28. - Balkau B, Lapoz L. Certification of cause of death in French diabetic patients. J Epidemiol Community Health 1992;46(1): 63-65
  29. - Will J, Vinicor F, Stevenson J. Recording of diabetes on death certificates: has it improved? J Clin Epidemiol 2001; 54(3): 239–244
  30. - Muhlhauser I, Sawicki P, Blank M, Overmann H, Richter B, Berger M. Reliability of cause of death in persons with type I diabetes. Diabetologia 2001; 45(11): 1490–1497
  31. - Jedrychowski W, Mroez E, Wiernikowski A, Flak E. Validity study on the certification and coding of underlying causes of death for the mortality statistic. Prz Epidemiol 2001; 55(3): 313–322
  32. - Lu TH, Tsau SM, Wu TC. The automated classification of medical entities (ACME) system objectively assessed the appropriateness of underlying cause-of-death certification and assignment. J Clin Epidemiol 2005; 58(12):1277–1281.
  33. - Curb JD, Ford CE, Pressel S, Palmer M, Babcock C, Hawkins CM. Ascertainment of vital status through the National Death Index and the Social Security Administration. Am J Epidemiol 1985; 121(5):754–766.