Underreporting of external cause codes in the Finnish Hospital Discharge Register

Philippe Lunetta, Antti Impinen, Anne Lounamaa

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"Background: Hospital discharge data ( HDD) represent one of the most valuable information sources for injury prevention and control. Objectives: To investigate external code of injury ( E-code) underreporting in the Finnish National Hospital Discharge Register from 1 January 1987 to 31 December 2004. Material and methods: HDD for discharges with an injury as the main diagnosis were extracted from the FNHDR. The selection was made using codes for nature of injury ( 198721995, ICD-9; 1996-2004, ICD-10). The proportion of injury discharges with a missing E-code was examined by sex, age, hospital districts, type of hospital, duration of hospitalization, and nature of injury. Results: In 432,549 ( 23.1%) of the recorded 1,868,519 discharges, an E-code was missing. The proportion of the discharges with a missing E-code varied among the above variables. During the period 1987-2004, the overall E-code underreporting decreased from 18.0% to 12.8%. The introduction of the ICD-10 in 1996 was followed by a dramatic increase ( up to 57.5% of all discharges) in E-code underreporting. Conclusions: More attention ought to be dedicated to teaching and periodic training on the use of E-codes. Educational activities should specifically target the medical doctors, who, in Finland, are responsible for assigning the E-codes."
Original languageEnglish
JournalScandinavian Journal of Public Health
Pages (from-to)870-874
Number of pages5
Publication statusPublished - 2008
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 319 Forensic science and other medical sciences

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