General Obstetrics and Gynecology: ObstetricsAccuracy of obstetric diagnoses and procedures in hospital discharge data
Section snippets
Material and methods
This study was undertaken as part of the California Hospital Outcomes Program, a legislatively mandated effort to improve the quality of hospital care and respond to the needs of purchasers and consumers by publishing risk-adjusted outcomes reports. These reports are based on the Patient Discharge Data Set, which includes an abstract of every discharge from every nonfederal licensed hospital in California. Each abstract lists the patient's birth date, sex, race, ZIP code, encrypted social
Results
We received 1614 of the 1662 records that we requested from the participating hospitals (97.1%). Three of these records did not actually represent deliveries; 1611 records were abstracted (30.3% primary cesarean, 18.9% repeat cesarean, 51.0% vaginal). This cohort had a weighted mean (SD) age of 28.0 (6.5) years and a racial/ethnic composition similar to the target population (55% white, 8% African American, 8% Asian, 29% Hispanic, 0.1% Native American, 0.8% “other”).
Table I, Table III, Table V
Comment
The current study may represent the most comprehensive published analysis of the validity of obstetric diagnosis and procedure codes on hospital discharge abstracts in the United States. After recoding 1611 obstetric records from 52 hospitals, we found that validity varied widely across procedures and conditions. Surgical procedures such as cesarean and instrumented vaginal delivery were accurately reported, with sensitivities and PPVs exceeding 90%. Episiotomy was underreported, particularly
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Supported by the California Office of Statewide Health Planning and Development, Agreement 00-0162.