Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Validity of the Diagnosis of Acute Myocardial Infarction in Korean National Medical Health Insurance Claims Data: The Korean Heart Study (1)

  • Kimm, Hee-Jin (Institute for Health Promotion, Cardiovascular Genome Center, Yonsei University) ;
  • Yun, Ji-Eun (Institute for Health Promotion, Cardiovascular Genome Center, Yonsei University) ;
  • Lee, Sang-Hak (Institute for Health Promotion, Cardiovascular Genome Center, Yonsei University) ;
  • Jang, Yang-Soo (Institute for Health Promotion, Cardiovascular Genome Center, Yonsei University) ;
  • Jee, Sun-Ha (Institute for Health Promotion, Cardiovascular Genome Center, Yonsei University)
  • Published : 2012.01.31
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Abstract

Background and Objectives: Medical insurance claims (MIC) data are one of the largest sources of outcome data in the form of International Classification of Diseases (ICD) codes. We evaluated the validity of the ICD codes from the Korean National MIC data with respect to the outcomes from acute myocardial infarction (AMI) in the Korean Heart Study. Subjects and Methods: Baseline information was obtained from health examinations conducted from 1994 to 2001. Outcome information regarding the incidence of AMI came from hospital admission discharge records from 1994 to 2007. Structured questionnaires were sent to 98 hospitals. In total, 107 cases of AMI with ICD codes of I21- (93 men, 26-73 years of age) were included in the final analyses. ICD code accuracy and reliability (kappa) for AMI were calculated. Results: A large number of AMI cases were from hospitals located in the Seoul area (75.9%). The accuracy of AMI was 71.4%, according to World Health Organization criteria (1997-2000, n=24, kappa=0.46) and 73.1% according to the European Society of Cardiology/American College of Cardiology (ESC/ACC) criteria (2001-2007, n=83, kappa=0.74). An age of 50 years or older was the only factor related to inaccuracy of codes for AMI (odds ratio, 4.6; 95% confidence interval, 1.2-17.7) in patients diagnosed since January 2001 using ESC/ACC criteria (n=83). Conclusion: The accuracy for diagnosing AMI using the ICD-10 codes in Korean MIC data was >70%, and reliability was fair to good; however, more attention is required for recoding ICD codes in older patients.

Keywords

References

  1. International classification of diseases and related health problems: Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death. 10th ed. Geneva: World Health Organization;1992.
  2. Surjan G. Questions on validity of international classification of diseases-coded diagnosis. Int J Med Inform 1999;54:77-95. https://doi.org/10.1016/S1386-5056(98)00171-3
  3. Hsia DC, Ahern CA, Ritchie BP, Moscoe LM, Krushat WM. Medicare reimbursement accuracy under the prospective payment system, 1985 to 1988. JAMA 1992;268:896-9. https://doi.org/10.1001/jama.1992.03490070078046
  4. Park JK, Kim KS, Kim CB, et al. The accuracy of ICD codes for cerebrovascular diseases in medical insurance claims. Korean J Prev Med 2000;33:76-82.
  5. Hong JS, Kang HC, Lee SH, Kim J. Long-term trend in the incidence of acute myocardial infarction in Korea: 1997-2007. Korean Circ J 2009;39:467-6. https://doi.org/10.4070/kcj.2009.39.11.467
  6. Kim HC, Kang DR, Nam CM, et al. Elevated serum aminotransferase level as a predictor of intracerebral hemorrhage: Korea Medical Insurance Corporation Study. Stroke 2005;36:1642-7. https://doi.org/10.1161/01.STR.0000173404.37692.9b
  7. Jee SH, Sull JW, Park J, et al. Body-mass index and mortality in Korean men and women. N Engl J Med 2006;355:779-87. https://doi.org/10.1056/NEJMoa054017
  8. Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined: a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol 2000;36:959-69. https://doi.org/10.1016/S0735-1097(00)00804-4
  9. Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, Arveiler D, Rajakangas AM, Pajak A. Myocardial infarction and coronary deaths in the World Health Organization MONICA Project: registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation 1994;90:583-612. https://doi.org/10.1161/01.CIR.90.1.583
  10. Hochholzer W, Buettner HJ, Trenk D, et al. New definition of myocardial infarction: impact on long-term mortality. Am J Med 2008;121:399-405. https://doi.org/10.1016/j.amjmed.2008.01.033
  11. Fleiss JL. Reliability of measurements. In: Fleiss JL, editor. The Design and Analysis of Clinical Experiments. New York: Wiley;1986. p.2-31.
  12. Watzlaf VJ. The medical record as an epidemiological database. Top Health Rec Manage 1987;7:61-7.
  13. Hsia DC, Krushat WM, Fagan AB, Tebbutt JA, Kusserow RP. Accuracy of diagnostic coding for Medicare patients under the prospective-payment system. N Engl J Med 1988;318:352-5. https://doi.org/10.1056/NEJM198802113180604
  14. Jencks SF, Williams DK, Kay TL. Assessing hospital-associated deaths from discharge data: the role of length of stay and comorbidities. JAMA 1988;260:2240-6. https://doi.org/10.1001/jama.1988.03410150088036
  15. Greenfield S, Aronow HU, Elashoff RM, Watanabe D. Flaws in mortality data: the hazards of ignoring comorbid disease. JAMA 1988;260:2253-5. https://doi.org/10.1001/jama.1988.03410150101039
  16. Hsia DC, Ahern CA, Ritchie BP, Moscoe LM, Krushat WM. Medicare reimbursement accuracy under the prospective payment system, 1985 to 1988. JAMA 1992;268:896-9. https://doi.org/10.1001/jama.1992.03490070078046
  17. Stausberg J, Lehmann N, Kaczmarek D, Stein M. Reliability of diagnoses coding with ICD-10. Int J Med Inform 2008;77:50-7. https://doi.org/10.1016/j.ijmedinf.2006.11.005
  18. Rawson NS, Malcolm E. Validity of the recording of ischaemic heart disease and chronic obstructive pulmonary disease in the Saskatchewan health care datafiles. Stat Med 1995;14:2627-43. https://doi.org/10.1002/sim.4780142404
  19. Kim JW. Analysis in the incidence and hospital use of Diabetes using medical insurance claim data. Diabetes in Korea 2005:42-55.
  20. Iezzoni LI, Moskowitz MA. Clinical overlap among medical diagnosis- related groups. JAMA 1986;255:927-9. https://doi.org/10.1001/jama.1986.03370070081030
  21. Fisher ES, Whaley FS, Krushat WM, et al. The accuracy of Medicare's hospital claims data: progress has been made, but problems remain. Am J Public Health 1992;82:243-8. https://doi.org/10.2105/AJPH.82.2.243
  22. Iezzoni LI, Burnside S, Sickles L, Moskowitz MA, Sawitz E, Levine PA. Coding of acute myocardial infarction: clinical and policy implications. Ann Intern Med 1988;109:745-51. https://doi.org/10.7326/0003-4819-109-9-745
  23. Kim D, Choi SY, Choi EK, et al. Distribution of coronary artery calcification in an asymptomatic Korean population: association with risk factors of cardiovascular disease and Metabolic syndrome. Korean Circ J 2008;38:29-35. https://doi.org/10.4070/kcj.2008.38.1.29
  24. Kim HJ, On YK, Sung JD, et al. Risk factors for predicting new-onset atrial fibrillation in persons who received health screening tests. Korean Circ J 2007;37:609-15. https://doi.org/10.4070/kcj.2007.37.12.609

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