Medical Injury Identification Using Hospital Discharge Data

Excerpt

Objective: Determine the feasibility of using routinely collected hospital data for medical injury surveillance. Methods: The development, validation, and testing of screening criteria for medical injury was based on International Classification of Disease code discharge diagnoses, using 2001 patient data from Wisconsin hospitals. Outcomes included sensitivity; specificity; rate of medical injury per the criteria; and impact of injury on length of stay and hospital charges. Results: Compared with medical records review, the sensitivity of the screening criteria was 59.9 percent and the specificity was 97.4 percent. The rate of medical injury was 133.3 per 1,000 hospitalizations. Patients with a medical injury had a 14.6 percent longer hospital stay and incurred 18.5 percent more in hospital charges than patients without a medical injury. Conclusions: Screening criteria applied to discharge diagnoses identify frequently occurring medical injuries with substantial impact. These criteria are being used to monitor patterns of medical injury in select Wisconsin hospitals to better determine the utility of using hospital discharge data to focus patient safety efforts.