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[Comparison of the French DRG based information system (PMSI) with the National Mesothelioma Surveillance Program
B Geoffroy-Perez1, E Imbernon, A Gilg Soit Ilg
1Département Santé Travail, Institut de Veille Sanitaire, 12, rue du Val-d'Osne, 94415 Saint-Maurice Cedex. b.geoffroyperez@invs.sante.fr
Background:
One of the main purposes of the French National Mesothelioma Surveillance Program is to estimate and follow the national incidence of pleural mesothelioma. We wanted to study the contribution of the French hospital national database as a valid source of mesothelioma incident cases.
Methods:
From the 1998 and 1999 hospital national database, medical records with a diagnosis code of mesothelioma or pleural cancer where selected among patients who resided in one of the 17 administrative divisions covered by the National Mesothelioma Surveillance Program in 1998. From these records, 506 patients in 1998 and 474 patients in 1999 where identified and matched with the National Mesothelioma Surveillance Program cases over the same period using indirect criteria of identification (sex, age, place of residence). Medical records of cases unknown by the National Mesothelioma Surveillance Program where consulted in one of the administrative divisions.
Results:
Only two-thirds of the registered cases of the National Mesothelioma Surveillance Program could be matched with a patient identified in the hospital national database with a diagnosis of mesothelioma registered during the same year. Consultation of the medical records showed that 1) certified cases registered in the National Mesothelioma Surveillance Program where often (83%) found in the hospital national database with a code of mesothelioma but 10 to 15% of the patients with a code of mesothelioma in the national hospital databases had a different diagnosis according to their medical records; 2) 65% of the patients with a code of mesothelioma in the national hospital databases that where unknown from the National Mesothelioma Surveillance Program in 1998 and 55% in 1999 where prevalent cases; 3) 3 suspected cases had not been reported to the National Mesothelioma Surveillance Program.
Conclusion:
Because of lack of diagnosis certification, mistakes in encoding diagnosis and the fact that incident and prevalent cases cannot be distinguished in the hospital national database make it impossible to estimate the mesothelioma incidence solely from this source of data. However, the hospital claim databases constitute a complementary source of information for the active search of incident cases performed by the National Mesothelioma Surveillance Program.
Insights
The French hospital national database cannot solely estimate mesothelioma incidence due to data limitations. However, it serves as a valuable complementary source for the National Mesothelioma Surveillance Program to identify potential cases.
Area of Science:
- Epidemiology
- Public Health
- Oncology
Background:
- The French National Mesothelioma Surveillance Program aims to track national pleural mesothelioma incidence.
- Assessing the French hospital national database as a source for mesothelioma cases is crucial for surveillance.
Purpose of the Study:
- To evaluate the French hospital national database's utility in identifying incident mesothelioma cases.
- To compare mesothelioma case data between the national surveillance program and the hospital database.
Main Methods:
- Selected patients from the 1998-1999 hospital database with mesothelioma or pleural cancer diagnoses.
- Matched identified patients with the National Mesothelioma Surveillance Program using demographic criteria.
- Reviewed medical records for cases not initially identified by the surveillance program.
Main Results:
- Two-thirds of surveillance cases were matched in the hospital database.
- 83% of surveillance cases had a mesothelioma code in the hospital database, but 10-15% had different diagnoses.
- A significant proportion (65% in 1998, 55% in 1999) of unmatched hospital cases were prevalent, not incident.
Conclusions:
- The hospital database alone is insufficient for estimating mesothelioma incidence due to diagnosis coding issues and inability to distinguish case types.
- Hospital databases are a useful supplementary resource for active mesothelioma case finding by surveillance programs.
