Dataset Information

Validation of intellectual disability coding through hospital morbidity records using an intellectual disability population-based database in Western Australia.

ABSTRACT: OBJECTIVES:To investigate how well intellectual disability (ID) can be ascertained using hospital morbidity data compared with a population-based data source. DESIGN, SETTING AND PARTICIPANTS:All children born in 1983-2010 with a hospital admission in the Western Australian Hospital Morbidity Data System (HMDS) were linked with the Western Australian Intellectual Disability Exploring Answers (IDEA) database. The International Classification of Diseases hospital codes consistent with ID were also identified. MAIN OUTCOME MEASURES:The characteristics of those children identified with ID through either or both sources were investigated. RESULTS:Of the 488?905 individuals in the study, 10?218 (2.1%) were identified with ID in either IDEA or HMDS with 1435 (14.0%) individuals identified in both databases, 8305 (81.3%) unique to the IDEA database and 478 (4.7%) unique to the HMDS dataset only. Of those unique to the HMDS dataset, about a quarter (n=124) had died before 1?year of age and most of these (75%) before 1?month. Children with ID who were also coded as such in the HMDS data were more likely to be aged under 1?year, female, non-Aboriginal and have a severe level of ID, compared with those not coded in the HMDS data. The sensitivity of using HMDS to identify ID was 14.7%, whereas the specificity was much higher at 99.9%. CONCLUSION:Hospital morbidity data are not a reliable source for identifying ID within a population, and epidemiological researchers need to take these findings into account in their study design.

SUBMITTER: Bourke J

PROVIDER: S-EPMC5786126 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Validation of intellectual disability coding through hospital morbidity records using an intellectual disability population-based database in Western Australia.

Bourke Jenny J Wong Kingsley K Leonard Helen H

BMJ open 20180123 1

<h4>Objectives</h4>To investigate how well intellectual disability (ID) can be ascertained using hospital morbidity data compared with a population-based data source.<h4>Design, setting and participants</h4>All children born in 1983-2010 with a hospital admission in the Western Australian Hospital Morbidity Data System (HMDS) were linked with the Western Australian Intellectual Disability Exploring Answers (IDEA) database. The International Classification of Diseases hospital codes consistent wi ...[more]

PMID: 29362262

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Project description:Adults with intellectual disability have high health care needs. Despite frequent contact with health services, they often receive inadequate health care. One method to improve health care delivery is reasonable adjustments, that is, the adaptation of health care delivery such that barriers to participation are removed for the person with disability. A starting point for the provision of reasonable adjustments is recognition of intellectual disability during the health care contact. To determine rates and predictors of the recognition of intellectual disability during hospital admissions, and its impact on admission metrics, we examined a population of adults with intellectual disability identified from disability services datasets from New South Wales, Australia between 2005 and 2014. Recognition of intellectual disability was determined by the recording of an International Classification of Diseases 10th revision (ICD-10) diagnostic code for intellectual disability during a given hospital admission. We examined how recognition of intellectual disability related to length of hospital episodes. We found an overall low rate of recognition of intellectual disability (23.79%) across all hospital episodes, with the proportion of hospital episodes recognising intellectual disability decreasing from 2005-2015. Admissions for adults with complex health profiles (e.g., those with many comorbidities, those with Autism Spectrum Disorder, and those admitted for urgent treatment) were more likely to recognise intellectual disability, but admissions for adults with complexity in other domains (i.e., for those in custody, or those with drug and alcohol disorders) were less likely to recognise intellectual disability. Recognition of intellectual disability was associated with longer episodes of care, possibly indicating the greater provision of reasonable adjustments. To improve the recognition of intellectual disability for adults during health service contacts, we advocate for the implementation of targeted initiatives (such as a nationwide disability flag to be included in health service records) to improve the provision of reasonable adjustments.

Dataset Information

Validation of intellectual disability coding through hospital morbidity records using an intellectual disability population-based database in Western Australia.

Publications

Validation of intellectual disability coding through hospital morbidity records using an intellectual disability population-based database in Western Australia.

Similar Datasets

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