Reliability of Routinely Collected Hospital Data for Child Maltreatment Surveillance

BMC Public Health

Research Article

Garry S Waller¹  Kirsten McKenzie¹  Debbie A Scott¹  Margaret Campbell¹ 

[1] National Centre for Health Information Research and Training, School of Public Health, Queensland University of Technology, Victoria Park Road, 4059, Kelvin Grove, QLD, Australia;

关键词: Sexual Abuse;    Child Maltreatment;    Medical Record Review;    Psychological Abuse;    Unintentional Injury;   

DOI  :  10.1186/1471-2458-11-8

 received in 2010-07-28, accepted in 2011-01-05,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundInternationally, research on child maltreatment-related injuries has been hampered by a lack of available routinely collected health data to identify cases, examine causes, identify risk factors and explore health outcomes. Routinely collected hospital separation data coded using the International Classification of Diseases and Related Health Problems (ICD) system provide an internationally standardised data source for classifying and aggregating diseases, injuries, causes of injuries and related health conditions for statistical purposes. However, there has been limited research to examine the reliability of these data for child maltreatment surveillance purposes. This study examined the reliability of coding of child maltreatment in Queensland, Australia.MethodsA retrospective medical record review and recoding methodology was used to assess the reliability of coding of child maltreatment. A stratified sample of hospitals across Queensland was selected for this study, and a stratified random sample of cases was selected from within those hospitals.ResultsIn 3.6% of cases the coders disagreed on whether any maltreatment code could be assigned (definite or possible) versus no maltreatment being assigned (unintentional injury), giving a sensitivity of 0.982 and specificity of 0.948. The review of these cases where discrepancies existed revealed that all cases had some indications of risk documented in the records. 15.5% of cases originally assigned a definite or possible maltreatment code, were recoded to a more or less definite strata. In terms of the number and type of maltreatment codes assigned, the auditor assigned a greater number of maltreatment types based on the medical documentation than the original coder assigned (22% of the auditor coded cases had more than one maltreatment type assigned compared to only 6% of the original coded data). The maltreatment types which were the most 'under-coded' by the original coder were psychological abuse and neglect. Cases coded with a sexual abuse code showed the highest level of reliability.ConclusionGiven the increasing international attention being given to improving the uniformity of reporting of child-maltreatment related injuries and the emphasis on the better utilisation of routinely collected health data, this study provides an estimate of the reliability of maltreatment-specific ICD-10-AM codes assigned in an inpatient setting.

【 授权许可】

CC BY   
© McKenzie et al; licensee BioMed Central Ltd. 2011