Miscoding of hospital discharges as acute myocardial infarction: Implications for surveillance programs aimed at elucidating trends in coronary artery disease

Gemma T. Kennedy, Michael P. Stern, Michael H. Crawford

    Research output: Contribution to journalArticle

    45 Citations (Scopus)

    Abstract

    The current decline in coronary artery disease mortality (CAD) may be a result of a declining population risk or of a declining case-fatality rate. Information on incidence trends for myocardial infarction (MI) could be used to distinguish between these 2 possibilities. Hospital discharge codes for MI (ICDCM-410) could be used as a convenient proxy for incidence trends, provided that coding of hospital discharges is sufficiently accurate. To evaluate the accuracy of medical records coding of patients signed out with an acute MI code (ICDCM-410), we compared them to an independent cardiology surveillance study of all patients with acute MI admitted to a large county teaching hospital. Over a 12-month period, 110 patients were coded as ICDCM-410 by medical records, but only 67 of these were detected by cardiology surveillance. The charts of the 43 patients not detected by surveillance were reviewed. In none of the 43 was evidence of acute MI found. In 28 of the 43, the discharge summaries listed rule out MI or status post-MI readmitted for further diagnostic workup, but were miscoded as ICDCM-410. Twelve of the 43 patients had cardiac arrests but were coded as ICDCM-410, even though there was no evidence of MI. Therefore, erroneous coding of patients as acute MI (ICDCM-410) may conceal a true downward trend in the incidence of CAD.

    Original languageEnglish (US)
    Pages (from-to)1000-1002
    Number of pages3
    JournalThe American Journal of Cardiology
    Volume53
    Issue number8
    DOIs
    StatePublished - Apr 1 1984

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    Coronary Artery Disease
    Myocardial Infarction
    Cardiology
    Medical Records
    Mortality
    Incidence
    County Hospitals
    Proxy
    Heart Arrest
    Teaching Hospitals
    Clinical Coding
    Population

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

    Cite this

    Miscoding of hospital discharges as acute myocardial infarction : Implications for surveillance programs aimed at elucidating trends in coronary artery disease. / Kennedy, Gemma T.; Stern, Michael P.; Crawford, Michael H.

    In: The American Journal of Cardiology, Vol. 53, No. 8, 01.04.1984, p. 1000-1002.

    Research output: Contribution to journalArticle

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