Which ICD-9-CM codes should be used for bronchiolitis research?

BACKGROUND: Bronchiolitis is a common respiratory disorder in children. Although there are specific ICD-9-CM diagnosis codes for bronchiolitis, the illness is often coded using broader diagnosis codes. This creates the potential for subject misclassification if researchers rely on specific diagnosis codes when assembling retrospective cohorts. Here we challenge the common research practice of relying on specific diagnosis codes for bronchiolitis. METHODS: We examined the use of diagnosis codes for the first episode of bronchiolitis, bronchitis, acute asthma, and bronchospasm and wheezing, in children younger than six and 24 months in the State of California Medic-Aid database. We categorized codes as narrow or broad diagnosis codes. We compared patient, geographic, and temporal characteristics of the different diagnoses codes. RESULTS: We identified visits from 48,732 children for first episode of wheezing illness. We retained 48,269 who had the diagnosis codes and data of interest. Diagnosis codes for acute asthma were widely used, even in children younger than six months in whom a diagnosis code for bronchiolitis would have been anticipated. The temporal pattern was similar across all diagnoses. Antipyretics were prescribed more often in those with diagnosis codes for bronchiolitis and bronchitis. Other statistically significant differences were too small to usefully distinguish the groups. There was substantial geographic variability in the diagnosis codes selected. CONCLUSION: Users of Medic-Aid administrative data should generally favor broad rather than narrow definitions of bronchiolitis and should perform sensitivity analysis comparing broad and narrow definitions.

AHRA survey: film library practices.

Presented here are the highlights of the Film Library Practices Report, taken from the 92-page report published by the AHRA in November 1996. Administrators may find information useful for improving their departments, which function most efficiently with smooth running libraries. The survey of AHRA members covers such topics as staffing, storage, copy policies, PACS and problem areas.

Future health services managers' and health information managers' views on information technology: a pilot survey.

This pilot survey examined the views of a sample of health service managers (HSMs) and health information managers (HIMs) undertaking tertiary studies about the application of information technology (IT) in health care. The survey was based on a questionnaire designed as part of a 1994 study of health service executives (HSEs) commissioned by the Australian College of Health Service Executives (ACHSE). We examined views about current and future IT expenditure, satisfaction with IT, impact of IT on quality and efficiency and the future use of electronic medical records and optical disk storage. Results identify differences and some similarities between respondent groups on these issues. The paper explores these differences and similarities and provides insight into the views held by future HSMs and HIMs.

Regional analysis of functions and demographics of health information managers.

Based on the findings of this study, HIM professionals' tasks or functions tend to vary across regions and in relation to levels of experience. As experience increased for RRAs, the task performed by them tended to be more management related. All other HIM professionals performed tasks that were more related to data collection than management. The most frequent title for the RRA (Director/manager/chief of medical records or HIM) was also more related to management activities while the title for the ART (Coder) was directly related to data collection. The majority of all HIM professionals work in acute care with approximately 3-8 percent working in long term care, ambulatory care, mental health care, and other healthcare settings such as software companies or health departments. The two most important predictors of salary across all regions were years of experience and educational level. When experience and education were controlled for, there was a slight salary advantage for males in the Midwest and West regions.

Health workforce planning: an analysis of employer demand pertaining to the Victorian medical record administration & diagnostic coding workforces.

In 1990, LaTrobe University introduced the world's first Post-Graduate Diploma in Nosology, in response to unmet demand for diagnostic coders in Victoria. After the first graduates entered employment, a two-part study was undertaken. The composition, employment levels and projected institutional demand for the coding workforce (comprising medical record administrator coders, Nosologists and "unqualified" coders) were ascertained. In parallel, the current employment levels and projected demand for the institutional medical record administrator workforce also were investigated. The institutional variables of major health care role, annual inpatient discharges and operating sector were found to impact upon employment levels and demand for both workforces by current, prospective and non-employers. The study identified a minimal projected demand for nosologists, the reasons for which are postulated, and negligible projected demand for nonqualified coding personnel. The results highlight a health current and projected employer demand for both medical record administrators and medical record administrator coders.

HIMAA workforce survey 1991/1992.

In 1991, and again in 1992, the Health Information Management Association of Australia (HIMAA), formerly Medical Record Association of Australia (MRAA), distributed a Workforce Survey to all members to collect information about the demographic, professional and employment characteristics of HIMAA members. There was a response rate 66.8% in 1991 and 40% in 1992, which rise to 80.9% in 1991 and 51.7% in 1992 for responses from full members. The collection will continue on an annual basis, providing a cumulative database and the opportunity for trend analysis.

Results from the 1989 member employment survey.

This is the first three articles reporting on the results of the 1989 AMRA Member Employment Survey. The purpose of this article is to describe the survey and provide general salary information. The second article will provide more detailed salary data and the third will address other issues related to nontraditional employment in the medical record profession.