TY - JOUR
T1 - Reconciliation of international administrative coding systems for comparison of colorectal surgery outcome
AU - Munasinghe, A.
AU - Chang, D.
AU - Mamidanna, R.
AU - Middleton, S.
AU - Joy, M.
AU - Penninckx, F.
AU - Darzi, A.
AU - Livingston, E.
AU - Faiz, O.
AU - AUTHOR GROUP
AU - Chang, David
AU - Dalton, Stephen
AU - Engel, Alexander
AU - Faiz, Omar
AU - Livingston, Ed
AU - Mahmoud, Najjia
AU - Rabaglia, Jennifer L.
AU - Ramamoorthy, Sonia
AU - Singh, Baljit
AU - Tollenaar, Rob
AU - van Berge Henegouwen, Mark I.
PY - 2014
Y1 - 2014
N2 - Aim Significant variation in colorectal surgery outcomes exists between different countries. Better understanding of the sources of variable outcomes using administrative data requires alignment of differing clinical coding systems. We aimed to map similar diagnoses and procedures across administrative coding systems used in different countries. Method Administrative data were collected in a central database as part of the Global Comparators (GC) Project. In order to unify these data, a systematic translation of diagnostic and procedural codes was undertaken. Codes for colorectal diagnoses, resections, operative complications and reoperative interventions were mapped across the respective national healthcare administrative coding systems. Discharge data from January 2006 to June 2011 for patients who had undergone colorectal surgical resections were analysed to generate risk-adjusted models for mortality, length of stay, readmissions and reoperations. Results In all, 52544 case records were collated from 31 institutions in five countries. Mapping of all the coding systems was achieved so that diagnosis and procedures from the participant countries could be compared. Using the aligned coding systems to develop risk-adjusted models, the 30-day mortality rate for colorectal surgery was 3.95% (95% CI 0.86-7.54), the 30-day readmission rate was 11.05% (5.67-17.61), the 28-day reoperation rate was 6.13% (3.68-9.66) and the mean length of stay was 14 (7.65-46.76) days. Conclusion The linkage of international hospital administrative data that we developed enabled comparison of documented surgical outcomes between countries. This methodology may facilitate international benchmarking
AB - Aim Significant variation in colorectal surgery outcomes exists between different countries. Better understanding of the sources of variable outcomes using administrative data requires alignment of differing clinical coding systems. We aimed to map similar diagnoses and procedures across administrative coding systems used in different countries. Method Administrative data were collected in a central database as part of the Global Comparators (GC) Project. In order to unify these data, a systematic translation of diagnostic and procedural codes was undertaken. Codes for colorectal diagnoses, resections, operative complications and reoperative interventions were mapped across the respective national healthcare administrative coding systems. Discharge data from January 2006 to June 2011 for patients who had undergone colorectal surgical resections were analysed to generate risk-adjusted models for mortality, length of stay, readmissions and reoperations. Results In all, 52544 case records were collated from 31 institutions in five countries. Mapping of all the coding systems was achieved so that diagnosis and procedures from the participant countries could be compared. Using the aligned coding systems to develop risk-adjusted models, the 30-day mortality rate for colorectal surgery was 3.95% (95% CI 0.86-7.54), the 30-day readmission rate was 11.05% (5.67-17.61), the 28-day reoperation rate was 6.13% (3.68-9.66) and the mean length of stay was 14 (7.65-46.76) days. Conclusion The linkage of international hospital administrative data that we developed enabled comparison of documented surgical outcomes between countries. This methodology may facilitate international benchmarking
U2 - https://doi.org/10.1111/codi.12624
DO - https://doi.org/10.1111/codi.12624
M3 - Article
C2 - 24661398
SN - 1462-8910
VL - 16
SP - 555
EP - 561
JO - Colorectal disease
JF - Colorectal disease
IS - 7
ER -