Validating injury-related diagnoses by physicians: an analysis of 62, 269 hospitalizations from a large hospital in Changsha, China. Issue 10 (October 2020)

• Record Type: Journal Article
• Authors: He, Qiong; Tong, Jin; Jin, Min; Hua, Junjie; Schwebel, David C.; Zhang, Jing; Hu, Guoqing
• Is Part Of: Injury. Volume 51:Issue 10(2020)
• Page Start: 2230
• Page End: 2234
• Publication Date: 2020-10
• Subjects: Injury -- Hospitalization -- Diagnosis -- Physician -- China; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2020.07.004
• Languages: English
• ISSNs: 0020-1383

Abstract

Highlights: Physicians' diagnoses only reported 405 (40%) of the 1011 injury-related hospitalizations. The proportions of under-reporting, lack of cause specificity, and misclassification errors were 50.5%, 7.9% and 1.5%, respectively. The proportion of diagnostic errors remained relatively similar across patient sex, intent of injury, and cause of injury subgroups, but varied substantially across patient age groups. Abstract: Objective: To assess the accuracy of injury-related hospitalization diagnoses by physicians in China. Methods: 62, 269 hospitalizations between 2014 and 2016 at a large hospital in Changsha, China were assessed. We considered three types of diagnostic errors: under-reporting, lack of cause specificity, and misclassification across injury causes. Diagnosis and coding of diseases were ascertained by professional coders based on the tenth International Classification of Disease (ICD-10). Chi square tests examined the proportion difference across subgroups of patient demographics, injury intent, and injury cause. Results: The 62, 269 records included 1011 injury-induced hospitalizations, but physicians' diagnoses only reported 405 (40%) of the 1011 hospitalizations as injury-related. The proportions of under-reporting, lack of cause specificity, and misclassification errors, respectively, were 50.5%, 7.9% and 1.5%. The proportion of diagnostic errors was relatively similar across patient sex, intent of injury, and cause of injury subgroups, but varied substantially across patient age groups. Conclusion: Physicians' diagnoses frequently omitted injury-induced hospitalizations. Such errors will impact injury research and policy-making when they are undetected and uncorrected.