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[Medical information system (PMSI) does not adequately identify severe trauma].

A Perozziello1, T Gauss2, A Diop1

  • 1Département d'informations médicales, groupe hospitalier Paris Nord Val-de-Seine, Assistance publique-Hôpitaux de Paris (AP-HP), Paris et Clichy, 92118 Clichy, France.

Revue D'Epidemiologie Et De Sante Publique
|December 10, 2017
PubMed
Summary
This summary is machine-generated.

Diagnosis Coding Category 26 (DCC26) is inadequate for identifying severe trauma victims, leading to underfunding. Incorporating the Trauma Related Injury Severity Score (TRISS) can improve trauma coding accuracy and resource allocation for better patient care.

Keywords:
CostsCoûtsHospital mortalityIncomesMortalité hospitalièreMultiple traumasPMSIPolytraumatismeRecettesScores de gravitéSeverity Scores

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Area of Science:

  • Trauma care and hospital resource management.
  • Medical coding and classification systems.
  • Injury severity assessment.

Background:

  • Accurate hospital resource allocation relies on precise case coding.
  • Multiple trauma (DCC26) is a primary diagnosis-coding category for trauma victims, influencing funding levels.
  • The study questions the adequacy of DCC26 in identifying all severe trauma cases.

Purpose of the Study:

  • To evaluate the effectiveness of DCC26 in identifying severe trauma victims.
  • To assess the accuracy of DCC26 compared to established injury severity scores.
  • To propose improvements for trauma coding to ensure appropriate resource allocation.

Main Methods:

  • Analysis of data from three Level 1 trauma centers over two years.
  • Comparison of patients coded as DCC26 versus non-DCC26.
  • Utilized Injury Severity Score (ISS), Trauma Related Injury Severity Score (TRISS), and in-hospital mortality for assessment.
  • Examined hospital resource utilization and expenditures.

Main Results:

  • DCC26 identified a more severely injured patient group but missed many severe trauma cases.
  • In the non-DCC26 group, 35% had an ISS > 15, indicating significant undercoding of severe injuries.
  • Observed mortality was 10% among 2570 trauma victims analyzed.

Conclusions:

  • DCC26 is an insufficient coding category for accurately identifying all severe trauma patients.
  • Severe trauma patients often incur high costs related to intensive care and specialized resources.
  • The TRISS score is recommended to enhance trauma coding accuracy and optimize resource allocation.