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Reliability of the minimum basic dataset for diagnoses of cerebrovascular disease
I Hernández Medrano1, M Guillán1, J Masjuan1
1Servicio de Neurología, Unidad de Ictus, Hospital Universitario Ramón y Cajal. Madrid, España.
Insights
The Minimum Basic Data Set (MBDS) quality for cerebrovascular disease (CVD) is adequate for reliable clinical studies. Despite some coding and DRG assignment errors, the MBDS provides valid information for hospital management and research.
Area of Science:
- Healthcare Informatics
- Clinical Epidemiology
- Health Services Research
Background:
- The Minimum Basic Data Set (MBDS) is a key administrative database for hospital care, clinical studies, and management.
- A 2011 audit assessed the national MBDS reliability for hospital discharges.
- This study focuses on a sub-analysis of MBDS data for cerebrovascular disease (CVD).
Purpose of the Study:
- To evaluate the quality and reliability of the national MBDS for cerebrovascular disease (CVD) cases.
- To assess the accuracy of diagnostic coding and Diagnosis-Related Group (DRG) assignment for CVD.
- To determine if the MBDS is suitable for clinical studies and hospital management of CVD.
Main Methods:
- Utilized a representative sample of 11,209 Spanish MBDS discharge records from 2009.
- Analyzed ICD-9-CM codes (categories 430-438) for CVD as a primary diagnosis.
- Evaluated error rates in main diagnosis selection, classification, and DRG assignment.
Main Results:
- Analyzed 397 CVD discharges across 21 DRGs.
- Achieved an 81.87% diagnostic coding concordance rate.
- Observed a 2.26% selection error, 15.87% classification error, and 16.12% DRG error rate, with DRG errors impacting mortality risk assessment.
Conclusions:
- The MBDS demonstrates sufficient quality for valid information regarding CVD.
- Observed errors in coding and DRG assignment necessitate careful consideration.
- The hospital discharge registry, using MBDS data, is a valuable tool for CVD research and management.
Introduction:
The minimum basic dataset is the largest available hospital care administrative database that is used in clinical studies and hospital management in association with diagnosis-related groups (DRGs). In 2011, the quality of the national MBDS in hospital discharges was audited, in order to assess its reliability. This paper presents a sub-analysis of the results from that analysis which are referred to cerebrovascular disease (CVD).
Methods:
Using all discharge reports from the Spanish MBDS in 2009, a representative sample was obtained by stratified sampling and 11 209 records were evaluated. Outcome indicators were obtained to measure any differences observed between the national MBDS being evaluated and the hospital's original MBDS. Analysis of codes for CVD as a primary diagnosis was performed for ICD-9-CM diagnostic categories 430 through 438. We evaluated error rates in the selection and classification of main diagnoses, as well as in DRG assignment.
Results:
There were 397 discharges of cases of CVD which included 21 different DRGs. Diagnostic coding showed a concordance rate of 81.87%; the selection error rate was 2.26% and the classification error rate was 15.87%. The error rate in the DRG was 16.12% and associated with the greatest impact on the mortality risk level.
Conclusions:
While the errors we observed must be taken into account, data suggest that the quality of the MBDS for CVD is sufficient to ensure delivery of valid information. The hospital discharge registry serves as a valuable tool for use in studies of this disease.
