Abstract
BackgroundDespite widespread use of neonatal hospital discharge data, there are few published reports on the accuracy of population health data with neonatal diagnostic or procedure codes. The aim of this study was to assess the accuracy of using routinely collected hospital discharge data in identifying neonatal morbidity during the birth admission compared with data from a statewide audit of selected neonatal intensive care (NICU) admissions.MethodsValidation study of population-based linked hospital discharge/birth data against neonatal intensive care audit data from New South Wales, Australia for 2,432 babies admitted to NICUs, 1994–1996. Sensitivity, specificity and positive predictive values (PPV) with exact binomial confidence intervals were calculated for 12 diagnoses and 6 procedures.ResultsSensitivities ranged from 37.0% for drainage of an air leak to 97.7% for very low birthweight, specificities all exceeded 85% and PPVs ranged from 70.9% to 100%. In-hospital mortality, low birthweight (≤1500 g), retinopathy of prematurity, respiratory distress syndrome, meconium aspiration, pneumonia, pulmonary hypertension, selected major anomalies, any mechanical ventilation (including CPAP), major surgery and surgery for patent ductus arteriosus or necrotizing enterocolitis were accurately identified with PPVs over 92%. Transient tachypnea of the newborn and drainage of an air leak had the lowest PPVs, 70.9% and 83.6% respectively.ConclusionAlthough under-ascertained, routinely collected hospital discharge data had high PPVs for most validated items and would be suitable for risk factor analyses of neonatal morbidity. Procedures tended to be more accurately recorded than diagnoses.
Highlights
Despite widespread use of neonatal hospital discharge data, there are few published reports on the accuracy of population health data with neonatal diagnostic or procedure codes
While there is currently a statewide New South Wales (NSW) audit of babies who are admitted to neonatal intensive care units (NICU) for selected reasons [13], there is no populationbased reporting on all babies admitted to NICU or who suffer a major morbidity
During 1994–1996, there were 2927 babies born in perinatal centres in NSW with linked Midwives Data Collection (MDC)-Admitted Patient Data Collection (APDC) birth records that potentially met the Neonatal Intensive Care Units (NICUS) registration criteria and 2432 (83%) that linked to a NICUS record
Summary
Despite widespread use of neonatal hospital discharge data, there are few published reports on the accuracy of population health data with neonatal diagnostic or procedure codes. The aim of this study was to assess the accuracy of using routinely collected hospital discharge data in identifying neonatal morbidity during the birth admission compared with data from a statewide audit of selected neonatal intensive care (NICU) admissions. Despite widespread use of neonatal hospital discharge data [3,4,5], there are few published reports on the accuracy of population health data with neonatal diagnostic or therapeutic intervention codes[6]. Validation of neonatal outcomes in Australian hospital discharge data has been limited to diagnosis-related codes[7], health interventions and procedures are generally better reported in population health data and may be better markers of morbidity [8,9,10]. While there is currently a statewide New South Wales (NSW) audit of babies who are admitted to neonatal intensive care units (NICU) for selected reasons [13], there is no populationbased reporting on all babies admitted to NICU or who suffer a major morbidity
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