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Reliability of routinely collected hospital data for child maltreatment surveillance

Kirsten McKenzie1, Debbie A Scott, Garry S Waller

  • 1National Centre for Health Information Research and Training, School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove QLD Australia. k.mckenzie@qut.edu.au

BMC Public Health
|January 7, 2011
PubMed

Insights

This study assessed the reliability of child maltreatment coding in Australian hospitals. While generally reliable, psychological abuse and neglect were under-coded, highlighting areas for improved child injury surveillance.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Informatics

Background:

  • Child maltreatment surveillance is vital but hindered by data limitations.
  • Routinely collected hospital data (ICD codes) offer standardized injury information.
  • Reliability of ICD coding for child maltreatment needs further examination.

Purpose of the Study:

  • To evaluate the reliability of child maltreatment coding in Queensland, Australia.
  • To assess the accuracy of International Classification of Diseases, 10th Revision, Australian Modification (ICD-10-AM) codes for child maltreatment surveillance.
  • To identify specific types of maltreatment that may be under-coded.

Main Methods:

  • Retrospective medical record review and recoding.
  • Stratified sampling of hospitals and cases across Queensland.
  • Assessment of inter-coder reliability for maltreatment codes.

Main Results:

  • High overall reliability for assigning maltreatment codes (sensitivity 0.982, specificity 0.948).
  • Psychological abuse and neglect were frequently under-coded.
  • Sexual abuse codes demonstrated the highest reliability.

Conclusions:

  • ICD-10-AM codes are a reliable, though imperfect, tool for inpatient child maltreatment surveillance.
  • Improvements in coding practices are needed for psychological abuse and neglect.
  • Findings support the use of routinely collected health data for child injury research.
Abstract

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