Background: Monitoring Adverse Drug Event (ADE) admissions in New Zealand using ICD coding is a convenient and cost effective method. However, under-recording or inaccurate coding of ADE admissions may limit the accuracy and usefulness of this method.
Aims: The aim of this study is to define the accuracy and reliability of ADE admission coding in hospital discharge data of older people in New Zealand.
Methods: This study is a retrospective review of hospital records and ICD coding. 1000 medical records of people aged 65 years and older who are admitted due to bleeding, falls and hypoglycemia from January to December 2015 from three DHBs (CMDHB, ADHB, WDHB) will be selected. The full medical record associated with the index admission will be analyzed and each set of notes will be screened to find the presence of ADE. The degree of certainty of ADE will be categorized into three: Definite/Contributing/No ADE. The objective of this records review study is to determine whether the index admission was associated with an ADE and, if so, my findings will be compared with codes assigned by coders and ICD 10 AM codes associated with ADE. These data will be used to calculate the proportions of ADE related admissions accurately coded as ADE and to define the codes assigned to reflect ADE admissions. Then in-depth semi-structured interviews will be conducted with coders in different DHBs in order to understand how they code ADE admissions and what codes they use for coding ADEs and to explore how ADE admission coding are approached at different DHBs.
Significance:This research will help to explore how we can improve the efficiency of ADE ICD coding and findings from this research will also help to accurately define the burden of Adverse Drug Event admissions in older people in New Zealand.
The University of Auckland