IMPACT OF THE MODE OF INFORMATION RECENSEMENT ON THE MEDICO-ECONOMIC CLASSIFICATION OF HOSPITAL ADMISSION FOR MYOCARDIAL-INFARCTION IN THE CIVIL HOSPITALS OF LYON

The aim of the PMSI (Programme de Medicalisation du Systeme d'Informat ion) is to describe the activity of hospitals for budget allocation. T o control the quality of this information, the authors carried out a s tudy comparing the classification in homogenous disease groups (HDG) o btained from the PMSI with that obtained from the epidemiological data base of the PRIMA trial for patients admitted to the Civil Hospitals of Lyon for myocardial infarction between September 1st 1993 and Janua ry 31st 1995. Six hundred and fifty standardised hospital summaries we re reconstituted form PRIMA data and grouped using the GENRSA 3 softwa re. Five hundred and forty-one of these hospital stays were found in t he PMSI data base and grouped. The concordance not due to chance betwe en the two classifications was then assessed by the global kappa coeff icient. It was less than the 40 % threshold under which concordance no t due to chance is considered to be unlikely. The discordances were es sentially due to the presence of an associated diagnosis classifying t he hospital stay in the HDG corresponding to complicated myocardial in farction. The presence of a classifying associated diagnosis was obser ved significantly more often in the PRIMA than in the PMSI data base. This results in an underestimation of the hospital activity and could have important repercussions in terms of budget allocation.