医院出院代码和高估分娩期间严重的孕产妇病率住院住院
Johanna Quist-Nelson1, Marie-Louise Meng, Divya Mallampati
1Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, and the Department of Anesthesiology, the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, the Department of Population Health Sciences, and the Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina; and the Department of Obstetrics and Gynecology, University of California, San Francisco, San Francisco, California.
近20%的重症孕产妇发病率 (SMM) 在分娩住院期间的诊断是先前编码的,这表明潜在的转移错误而不是新的事件. 这凸显了需要审查SMM编码准确性的必要性.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 医疗保健信息学 医疗保健信息学
背景情况:
- 严重的孕产妇发病率 (SMM) 是产科护理质量的关键指标.
- 在分娩住院期间准确识别SMM对于患者安全和质量改善至关重要.
- 潜在的编码错误,如转移诊断,可以膨胀SMM率.
研究的目的:
- 为了确定在分娩住院期间记录的严重孕产妇发病率 (SMM) 诊断,这些诊断在之前的患者接触中也被编码.
- 评估可能被错误地传递的SMM诊断率作为新的事件.
- 评估编码实践对SMM监督的影响.
主要方法:
- 对2016年至2020年间分娩的孕妇患者进行了回顾性队列研究.
- 将SMM算法应用于出生住院记录和之前的接触 (怀孕,产前,产后).
- 主要结局:出生时住院的SMM诊断率也编码在以前的遭遇中.
主要成果:
- 1,380名 (1.8%) 的分娩患者被确定为SMM.
- 在那些在出生住院时拥有SMM代码的人中,有19.0%的人在之前的遭遇中记录了相同的SMM代码.
- 特定的SMM诊断显示了更高的倾向转移错误.
结论:
- 在出生时住院时诊断的SMM中,很大一部分可能代表了以前遭遇的转载错误.
- 这一发现表明,目前的SMM监测方法可能会高估新的SMM事件的发生率.
- 改善诊断编码准确性和SMM事件验证的建议是有必要的.
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