[Hospital admissions related to lung disease in Andalucia: 1993-1994]. / Ingresos de causa neumológica en hospitales de Andalucía: 1993-1994.

To determine the pneumological causes for hospital admission in Andalucia (Spain) and thereby improve knowledge of respiratory morbidity. From the Combined Minimum Data Base on admissions to Andalusian hospitals for 1993 and 1994, adjusted to the CIE-9-MC coding system, we analyzed main diagnoses registered. Cases with respiratory involvement were obtained, excluding patients under 7 years of age. Admissions for pneumological causes accounted for 6.3% of all admissions, with a total of 314 diagnostic categories, although 98.5% of all admissions were related to only 139 diagnoses. The 53 most frequent diagnostic categories accounted for 93% of patients and 55.2% of admissions were related to only 10 causes and led to 54.16% of all stays for pneumological diseases. Categories 486 and 481 (pneumonias), along with 496, 491.2 and 491.21 (diseases involving chronic air flow obstruction) were the most often used. Respiratory problems account for 6.23% of all hospital admissions in Andalucia, with lung infections and conditions falling under the category of chronic obstructive pulmonary disease being by far the most frequent pneumologically related reasons for hospitalization. The precise interpretation of diagnostic categories needs to be better defined in the coding system.

[Hospital morbidity statistics: the accuracy of the diagnosis reported in the discharge registry book]. / Estadísticas de morbididad hospitalaria: exactitud del diagnóstico notificado en el libro de registro de altas.

BACKGROUND: The registry book of admission and discharges (RBD) is operative in most public and private hospitals of this country. Currently its reformation is contemplated, consisting in a modification of the minimal set of basic data and its computerization. The aim of the present study was to evaluate the accuracy of the discharge diagnosis recorded in the RBD and to analyze the possible factors implicated in the current quality level. METHODS: In a sample of 9 hospitals from the Seville province, 2,634 discharges were selected with a stratified sampling process which was proportional to the number of discharges in each stratum during 1985. The accuracy of the diagnosis recorded in the RBD was estimated by comparing it with that in the clinical record (CR). RESULTS: The accuracy indexes showed that, for the large diagnostic groups, only in 45% of discharges the diagnosis coincided in both documents. The accuracy increased to 89% when the estimation was made after excluding those discharges where the diagnosis was not recorded in the RBD and/or in the CR (n = 1303). CONCLUSIONS: The fulfillment of the RBD appears as the main error source, followed by the selection of the major diagnosis and its transcription in the different documents of the circuit. It is concluded that a precondition for the success of a reformed RBD is to guarantee the fulfillment of data.