A validation of diagnostic codes for benign indications for gynecologic surgery in the canadian institutes for health information discharge abstract database (CIHI-DAD)

Background: Dementia prevalence is rising, and will double in the next 20 years. This study sought to understand the prevalence of dementia in hospitalized patients with stroke and TIA, differences in characteristics and impact on outcomes. Methods: Using the Canadian Institute of Health Information (CIHI) Discharge Abstract Database (DAD), all acute stroke and TIA admissions from April 2003 to March 2015 in Canada (excluding Quebec) were analyzed. Concurrent dementia at time of admission was assessed based on hospital diagnostic codes. Characteristics and in-hospital outcomes were compared in patients with vs. without dementia using chi-square and logistic regression. Results: During the observed period 464,741 patients were admitted to hospital for cerebrovascular syndromes (ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage (SAH) and TIA). Of those, 29,812 (6.4%) had a concurrent diagnosis of dementia, including 8.4% of patients ≥65 years. People with dementia had older median age (84 vs. 75 years; p<0.01), were more often female (59.6% vs. 49.3%; p<0.01) and more often had Charlson-Deyo comorbidity index ≥ 2 (62.1% v. 38.4%; p<0.01). They were less likely admitted with SAH (1.3% vs. 5.3%; p<0.01) and more likely coded as strokes with unidentified subtype (29.4% vs. 20.8%; p<0.01). Median length of stay (13 vs. 7 days; p<0.01) was longer. Patients with dementia were less likely discharged to another acute care facility (7.6% vs. 14.7%; p<0.01), rehabilitation facility (5.4% vs. 12.0%; p<0.01) or home independently (22.9% 48.9%; p<0.01); other outcomes are shown in the Table. Conclusions: Approximately 1 in 10 hospitalized stroke and TIA patients age ≥65 has coded dementia. Patients with stroke or TIA and dementia have higher mortality, face significantly more dependence after stroke and utilize greater healthcare resources than stroke patients without dementia. Early care planning and coordination are essential to optimize outcomes.

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Validation of perinatal data in the Discharge Abstract Database of the Canadian Institute for Health Information

Chronic Diseases in Canada ◽

10.24095/hpcdp.29.3.01 ◽

2009 ◽

Vol 29 (3) ◽

pp. 96-101 ◽

Cited By ~ 34

Author(s):

K.S. Joseph ◽

J. Mahey

Keyword(s):

Health Information ◽

Intraventricular Hemorrhage ◽

Distress Syndrome ◽

Sensitivity Analyses ◽

Perinatal Morbidity ◽

Discharge Abstract Database ◽

Canadian Institute ◽

Perinatal Data ◽

Improved Accuracy ◽

Perinatal Database

We compared perinatal information submitted to the Canadian Institute for Health Information (CIHI) hospitalization database with information submitted to the Nova Scotia Atlee Perinatal Database (NSAPD) in order to assess the accuracy of the CIHI data. Procedures such as Caesarean delivery were coded accurately (i.e. sensitivity of 99.8%; specificity of 98.7%). Postpartum hemorrhage, induction of labour and severe intraventricular hemorrhage also had sensitivity and specificity rates above 85% and 95%, respectively. Some diagnoses, defined differently in the two databases, were less accurately coded, e.g. respiratory distress syndrome (RDS) had a sensitivity of 50.9% and a specificity of 99.8%. Restriction to more severe forms of the disease improved accuracy, e.g. restriction of RDS to severe RDS in the NSAPD and identification of severe RDS in the CIHI database, using codes for RDS and intubation, resulted in a sensitivity of 100% and a specificity of 99.6%. Our study supports the use of CIHI data for national surveillance of perinatal morbidity, with the caveat that an understanding of clinical practice and sensitivity analyses to identify robust findings be used to facilitate inference.

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Hospital Diagnosis of Malnutrition: A Call for Action

Canadian Journal of Dietetic Practice and Research ◽

10.3148/70.1.2009.37 ◽

2009 ◽

Vol 70 (1) ◽

pp. 37-41 ◽

Cited By ~ 7

Author(s):

Mary Ann Bocock ◽

Heather H. Keller

Keyword(s):

Older Adults ◽

Health Care ◽

Health Information ◽

Hospital Admissions ◽

Care Facility ◽

International Classification Of Diseases ◽

Health Condition ◽

Care Utilization ◽

Discharge Abstract Database ◽

Term Care

The Canadian Institute for Health Information (CIHI) provides accurate health information needed to establish sound health care policies. The CIHI mandate is to develop and coordinate a uniform approach to health care information in Canada. The institute uses the International Classification of Diseases (ICD) system to record the most responsible diagnosis for each hospital admission. This investigation was conducted to determine if six ICD protein-calorie malnutrition (PCM) codes could be used for health care utilization analyses. Aggregate data (1996 to 2000) from the CIHI discharge abstract database were used. The data analyzed were the most responsible diagnoses data for the six PCM codes and a single summary statistic for all other “non-malnutrition” diagnoses for all long-term care facility residents aged 65 or older who were transferred to an acute care facility. In this population, fewer than five hospital admissions per year were assigned a PCM code. There were too few PCM cases to do trend analyses for morbidity or mortality. This study suggests a lack of recognition and documentation of PCM as a specific health condition in older adults. Lack of tracking of this diagnosis prevents documentation that could lead to policy changes to support older adults’ nutrition.

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