Research archive: Vol. 34 No.2

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Volume 34 Number 2: >> Challenges in Coding and Classification

	Asthma terminology and classification in hospital records Kirsten McKenzie and Sue Wood [ PDF ] Abstract Asthma is a national health priority area in Australia, and there is significant interest in capturing relevant detail about hospitalisations as a result of asthma. A public submission received by the National Centre for Classification in Health from a large teaching hospital in Victoria suggested that current classification terminology in ICD-10-AM did not adequately reflect the terms recorded in clinical inpatient records, and that patterns and severity of asthma better reflected current clinical terminology in Australian hospitals. The purpose of this study was to determine the validity of the public submission and inform future changes to ICD-10-AM. A representative sample of over 3000 asthma records across Australia and New Zealand were extracted, and the asthma terminology documented and codes assigned were recorded and analysed. The study concluded that there was little support for either pattern terminology or the current classification terminology; however, severity of asthma was commonly used in asthma documentation.
	Investigation of leukaemia and lymphoma AR-DRGs at a Sydney teaching hospital Beth Reid, Corinne Allen and Jean McIntosh [ PDF ] Abstract Using non-blinded methodology, this study checked the coding of acute leukaemia, non-acute leukaemia and lymphoma episodes assigned to the AR-DRGs R60 A, B, C and R61 A, B during the fiscal year 2000–2001 at a Sydney teaching hospital. The purpose was to investigate whether the assignment of fewer episodes of these diseases to the highest complexity AR-DRGs during that year compared to 1999–2000 was due to miscoding, or due to a true decrease in episodes. A check of all 242 episodes revealed a degree of miscoding (mainly under-coding) of complications and comorbidities that had caused a 15% DRG error rate; nevertheless, there was a true decrease in the highest complexity episodes. The error in DRG assignment may have caused some financial disadvantage to the hospital.
	Clinical coder training initiatives in Ireland Michelle Bramley and Beth Reid [ PDF ] Abstract The Hospital In-Patient Enquiry and National Perinatal Reporting System (HIPE & NPRS) Unit of the Economic and Social Research Institute in Ireland requested a review of its coder training programs and data quality initiatives, primarily because of the decision to implement a major change in Ireland’s morbidity classification in January 2005. In August 2004, a formative evaluation using qualitative methods was conducted to assess the Unit’s programs and initiatives. A number of opportunities for building on the solid frameworks the Unit has implemented were identified. In this paper, we focus on the Unit’s coder training programs. The Unit’s data quality initiatives will be discussed in a subsequent paper (Bramley & Reid 2005).
	Morbidity data quality initiatives in Ireland Michelle Bramley and Beth Reid [ PDF ] Abstract In 2004, the Hospital In-Patient Enquiry and National Perinatal Reporting System (HIPE & NPRS) Unit of the Economic and Social Research Institute in Ireland requested a review of its coder training programs and data quality initiatives, primarily because of the decision to implement a major change in the morbidity classification in January 2005. In August 2004, the authors conducted a formative evaluation using qualitative methods to assess the Unit’s programs. A number of opportunities for building on the solid framework the Unit has implemented were identified. The preceding paper focused on the Unit’s coder training programs (Bramley & Reid 2005). In this paper, the Unit’s data quality initiatives are examined.