Identification of hospitalizations for intentional self-harm when E-codes are incompletely recorded

摘要: CONTEXT: Suicidal behavior has gained attention as an adverse outcome of prescription drug use. Hospitalizations for intentional self-harm, including suicide, can be identified in administrative claims databases using external cause injury codes (E-codes). However, rates E-code completeness US government and commercial are low due to issues with hospital billing software. OBJECTIVE: To develop algorithm identify self-harm hospitalizations recorded psychiatric diagnosis the absence reporting. METHODS: We sampled (ICD-9 800-995) from two high E-coding completeness: 1999-2001 British Columbia, Canada data 2004 Nationwide Inpatient Sample. Our gold standard was a E950-E958. constructed algorithms these information on type presence specific diagnoses. RESULTS: The that sensitivity specificity poisoning, toxic effects, open wound elbow, wrist, or forearm, asphyxiation; plus depression, mania, personality disorder, psychotic adjustment reaction. This had 63%, 99% positive predictive value (PPV) 86% Canadian database. Values were 74, 98, 73%. PPV highest (80%) patients under 25 lowest those over 65 (44%). CONCLUSIONS : proposed may useful researchers attempting study incomplete reporting, especially among younger populations. Copyright © 2010 John Wiley & Sons, Ltd. Language: en