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The coverage of elective revascularisation procedure codes in the National Finnish Hospital Discharge Register

Jari Heiskanen1,2,3, Janne Martikainen4, Heikki Miettinen1,5

  • 1a Heart Center, Kuopio University Hospital , Kuopio , Finland.

Annals of Medicine
|August 6, 2016
PubMed

Insights

The Finnish National Hospital Discharge Register captures most coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) procedures. However, the classification of elective procedures in the register needs improvement for real-life effectiveness studies.

Area of Science:

  • Health Services Research
  • Medical Informatics
  • Cardiovascular Surgery

Background:

  • Administrative registers like the Finnish National Hospital Discharge Register (HDR) are valuable for real-life effectiveness studies.
  • While diagnostic codes in the HDR show high validity for coronary artery disease, the accuracy of procedure codes for revascularization (PCI and CABG) was unknown.

Purpose of the Study:

  • To assess the validity of procedure codes for percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in the Finnish National Hospital Discharge Register (HDR).
  • To evaluate the accuracy of classifying elective procedures within the HDR.

Main Methods:

  • Retrospective analysis of elective PCIs and CABGs performed at Kuopio University Hospital between 2007-2014.
  • Linking hospital unit's Special Electronic Medical Records (sEMR) data with the National Hospital Discharge Register (HDR) using personal identity codes.
  • Calculating sensitivity for procedure codes and the correct classification of elective procedures.

Main Results:

  • Sensitivity for PCI codes was 87.6% and for CABG codes was 98.0% when a one-day difference in procedure dates was allowed.
  • Only 62.1% of elective PCIs and 69.2% of CABGs were correctly classified as elective in the HDR.
  • Electivity data were missing for approximately one-third of the procedures.

Conclusions:

  • The Finnish National Hospital Discharge Register effectively captures the majority of PCI and CABG procedures, supporting its use in real-life effectiveness research.
  • The accuracy of classifying elective procedures in the HDR requires improvement, as a significant portion was misclassified or lacked electivity data.
  • This study highlights the potential of the HDR for evaluating real-world procedure effectiveness and informing evidence-based healthcare decisions.
Abstract

Keywords:
Registriescoronary artery bypasscoronary artery diseaseelectronic health recordspercutaneous coronary intervention

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