Background: Medical Devices (MDs) can be tracked in Portuguese hospital data using the International Classification of Diseases (ICD-9-CM) or a Medical Device Code (MDC). MCD provide information on MD brand and model, useful for health technology assessment. Objective: To evaluate the performance of MDC in identifying hospital episodes with Cardiac Implantable Electronic Devices (CIEDs) compared to ICD-9-CM. Methods: This retrospective study analyzed hospital episode data from 2015 to 2016. Hospitalizations for CIED insertion or replacement were identified using MDCs and ICD-9-CM codes. The number of episodes identified by each system was compared. Positive predictive value (PPV) and sensitivity of MDC against ICD-9-CM were calculated by CIED category and hospital. To illustrate the potential added value of the MDC information, we identified the top CIED models used and the variations in use and purchase prices across hospitals. Results: A total of 20,006 CIED episodes from 41 hospitals were identified, with 19,985 (99.9%) using ICD-9-CM codes and 2810 (14%) using MDCs. MDC sensitivity was below 35% for all CIED types, while PPV was generally high (> 0.8), except for CRT-P and CIED leads. CIED prices varied across hospitals. Conclusions: MDCs are not reliable for identifying CIED hospitalizations compared to ICD-9-CM. However, improving MDC data collection could enhance the fit of the data for health technology assessment.

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Identifiers for Cardiac Implantable Electronic Devices—A Data Quality Assessment of Administrative Hospital Data in Portugal

  • Mariana Lobo,
  • Sandra Couto,
  • Fernando Lopes,
  • José Silva-Cardoso,
  • Emilia Moreira,
  • Afonso Rocha,
  • Alberto Freitas

摘要

Background: Medical Devices (MDs) can be tracked in Portuguese hospital data using the International Classification of Diseases (ICD-9-CM) or a Medical Device Code (MDC). MCD provide information on MD brand and model, useful for health technology assessment. Objective: To evaluate the performance of MDC in identifying hospital episodes with Cardiac Implantable Electronic Devices (CIEDs) compared to ICD-9-CM. Methods: This retrospective study analyzed hospital episode data from 2015 to 2016. Hospitalizations for CIED insertion or replacement were identified using MDCs and ICD-9-CM codes. The number of episodes identified by each system was compared. Positive predictive value (PPV) and sensitivity of MDC against ICD-9-CM were calculated by CIED category and hospital. To illustrate the potential added value of the MDC information, we identified the top CIED models used and the variations in use and purchase prices across hospitals. Results: A total of 20,006 CIED episodes from 41 hospitals were identified, with 19,985 (99.9%) using ICD-9-CM codes and 2810 (14%) using MDCs. MDC sensitivity was below 35% for all CIED types, while PPV was generally high (> 0.8), except for CRT-P and CIED leads. CIED prices varied across hospitals. Conclusions: MDCs are not reliable for identifying CIED hospitalizations compared to ICD-9-CM. However, improving MDC data collection could enhance the fit of the data for health technology assessment.