NDLI: Efficiency of International Classification of Diseases, Ninth Revision, billing code searches to identify emergency department visits for blood or body fluid exposures through a statewide multicenter database.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Rosen, Lisa M. Liu, Tao Merchant, Roland C.
Spatial Coverage	Rhode Island
Description	Country affiliation: United States Author Affiliation: Rosen LM ( Department of Community Health, Alpert Medical School of Brown University, Providence, Rhode Island, USA.)
Abstract	BACKGROUND: Blood and body fluid exposures are frequently evaluated in emergency departments (EDs). However, efficient and effective methods for estimating their incidence are not yet established. OBJECTIVE: Evaluate the efficiency and accuracy of estimating statewide ED visits for blood or body fluid exposures using International Classification of Diseases, Ninth Revision (ICD-9), code searches. DESIGN: Secondary analysis of a database of ED visits for blood or body fluid exposure. SETTING: EDs of 11 civilian hospitals throughout Rhode Island from January 1, 1995, through June 30, 2001. PATIENTS: Patients presenting to the ED for possible blood or body fluid exposure were included, as determined by prespecified ICD-9 codes. METHODS: Positive predictive values (PPVs) were estimated to determine the ability of 10 ICD-9 codes to distinguish ED visits for blood or body fluid exposure from ED visits that were not for blood or body fluid exposure. Recursive partitioning was used to identify an optimal subset of ICD-9 codes for this purpose. Random-effects logistic regression modeling was used to examine variations in ICD-9 coding practices and styles across hospitals. Cluster analysis was used to assess whether the choice of ICD-9 codes was similar across hospitals. RESULTS: The PPV for the original 10 ICD-9 codes was 74.4% (95% confidence interval [CI], 73.2%-75.7%), whereas the recursive partitioning analysis identified a subset of 5 ICD-9 codes with a PPV of 89.9% (95% CI, 88.9%-90.8%) and a misclassification rate of 10.1%. The ability, efficiency, and use of the ICD-9 codes to distinguish types of ED visits varied across hospitals. CONCLUSIONS: Although an accurate subset of ICD-9 codes could be identified, variations across hospitals related to hospital coding style, efficiency, and accuracy greatly affected estimates of the number of ED visits for blood or body fluid exposure.
File Format	HTM / HTML
ISSN	0899823X
Issue Number	6
Volume Number	33
e-ISSN	15596834
Journal	Infection Control & Hospital Epidemiology
Language	English
Publisher	Cambridge University Press
Publisher Date	2012-06-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Communicable Diseases Discipline Epidemiology Blood-borne Pathogens Body Fluids Databases, Factual Emergency Service, Hospital Environmental Exposure International Classification Of Diseases Cluster Analysis Efficiency Statistics & Numerical Data Humans Logistic Models Predictive Value Of Tests Rhode Island Evaluation Studies Journal Article Multicenter Study Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Epidemiology Microbiology (medical)

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