VARIATIONS IN THE ACCURACY OF OBSTETRIC PROCEDURES AND DIAGNOSES ON BIRTH RECORDS IN WASHINGTON-STATE, 1989

The authors abstracted a sample of 7,536 hospital medical records to v alidate the accuracy of the coding of obstetric information on 1) birt h certificates, 2) a statewide computerized hospital discharge abstrac t data system, and 3) a linked file merging birth certificates and the hospital abstract data for Washington State deliveries occurring in 1 989. Measures of accuracy of coding of delivery method and obstetric p rocedures varied greatly among the 23 hospitals that participated in t he study. Computerized hospital discharge data were generally more com plete and accurate than were birth certificate data. The linked file w as more likely to identify obstetric procedures than was either source alone. For example, only 84.1% of cesarean deliveries noted in the ho spital charts were identified on birth certificates (range among hospi tals, 37-100%). Using the linked file, the authors identified 99.8% of cesarean deliveries (range, 97-100%). Linked birth certificate-hospit al abstract files may become an excellent source of data for epidemiol ogic and health care studies; however, further training of medical rec ord personnel and standardization of coding are needed to improve the quality of computerized data on obstetric events.