The inpatient care of patients with diabetes mellitus and foot ulcers. A validation study of the correspondence between medical records and the Swedish Inpatient Registry with the consequences for cost estimations

Citation
Gr. Tennvall et al., The inpatient care of patients with diabetes mellitus and foot ulcers. A validation study of the correspondence between medical records and the Swedish Inpatient Registry with the consequences for cost estimations, J INTERN M, 248(5), 2000, pp. 397-405
Citations number
17
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Journal title
JOURNAL OF INTERNAL MEDICINE
ISSN journal
09546820 → ACNP
Volume
248
Issue
5
Year of publication
2000
Pages
397 - 405
Database
ISI
SICI code
0954-6820(200011)248:5<397:TICOPW>2.0.ZU;2-F
Abstract
Objectives. To compare the correspondence of discharges and diagnoses betwe en medical records and an administrative database in diabetic patients with foot ulcers and to calculate inpatient costs from the different sources. Design. Discharge data from 117 prospectively followed patients were compar ed with information from the Swedish Inpatient Registry during the same tre atment period for each patient. Non corresponding discharges were retrospec tively reviewed in patient records. Costs of inpatient care were calculated from clinical sources and from,data selected in three different ways from the database. Information in medical records was assumed to represent the ' Gold Standard'. Setting. In-hospital treatment, multidisciplinary foot-care team. Subjects. A total of 117 diabetic patients with deep foot infections. Main outcome measures. Degree of database completeness and inpatient costs. Results. The degree of completeness of discharges in the database was 98%, but 8.6% of discharges had no code for diabetes and 13% were registered wit hout any foot related diagnosis code. Less than 20% of discharges were foun d with selection based on primary diagnosis 250.G only. Total inpatient cos ts varied from 2.7 to 13.3 million SEK (Swedish Kronor) depending on select ed diagnosis codes. Approximately 84% of all foot ulcer discharges could be found in the database if codes with both diabetes mellitus and foot ulcer diagnoses were selected. Conclusions. Inpatient costs for foot complications cannot be accurately es timated from the Inpatient Registry when based on primary diagnosis exclusi vely. Fairly good estimates at a low data acquisition cost can be made with a combination of foot related diagnoses together with codes for diabetes.