Is it reasonable to apply ICD-10 coding diagnoses to identify healthcare associated urinary tract infections?

Miss Karen Maglinao1, A/Prof Caroline Marshall1

1Melbourne Health, Parkville, Australia

 

Introduction: Australian healthcare services will now be required to monitor Healthcare-Associated Complications (HACS), which include a number of healthcare-associated infections. A diagnosis of HAC will be made using ICD-10 coding diagnoses documented in patient medical records. This study compared these diagnoses of healthcare associated urinary tract infections (HAUTI) with surveillance criteria as the gold standard to examine accuracy.

Methods: We compared designation of HAUTI according to ICD-10 codes with diagnoses using Centers for Disease Control National Healthcare Safety Network (CDC-NHSN) criteria for HAUTI and catheter-associated UTI (CAUTI). Coding uses diagnoses recorded by clinicians in the patient medical records with some corroborating information. CDC-NHSN definitions use strict criteria including time since admission, symptoms and culture results to assign a diagnosis of HAUTI.

Results: Eighty-four patients with an ICD-10 code of HAUTI with admission dates between 1 December 2016 and 28 February 2017 were reviewed and compared with a diagnosis using CDC-NHSN criteria. Of the 84 patients, 56 (67%) were considered HAUTI, 12 (14%) were UTI present on admission, 15 (18%) had no UTI and one patient had no information in the system. 37 of the 56 patients with HAUTI had IDCs in situ but only 16 met the CDC-NSHN CAUTI criteria.

Conclusion: We found that only 67% of HAUTI diagnoses using ICD-10 criteria were correlated with HAUTI using CDC-NHSN criteria, suggesting that using ICD-10 coding may not present a true rate of HAUTI. Coding methods cannot be easily changed. Improving documentation in medical notes may improve accuracy.

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The ACIPC is the peak body for Infection Prevention and Control professionals in the Australasian region. Our stated vision is the prevention and control of infection in our communities. We commenced in January 2012 bringing together the various State and Territory infection control associations formerly in AICA (The Australian Infection Control Association) to support and encourage collaboration across Australasia.

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