Abstract
A wide variety of hospital data is reported to and published by national groups intending to compare quality of care between institutions. The rate of deep venous thrombosis and pulmonary embolism (DVT/PE) after orthopaedic surgery is among those reported. In an effort to examine the validity of hospital data reported to these national groups, we looked deeper into the cases of DVT reported by our hospital to the University Health Services Consortium (UHC).
The rate of DVT/PE after orthopaedic surgical procedures reported to UHC for 2007 was 2.6% (33 cases). This rate is over twice the UHC mean for this same time period. Review of the 33 reported cases of DVT/PE revealed that only 12 were appropriately coded; if appropriately coded and reported, the DVT/PE rate would have been 0.95%.
The rates of DVT/PE reported by this institution to UHC result in that institution being characterised as having comparatively high rates of this complication. However, the validity of this characterisation should be questioned, based on inconsistencies seen in the institution's diagnostic coding. This investigation raises concerns that coding variations between institutions may prohibit accurate quantification of hospital complications and ought not be used for the purpose of benchmarking.
