Validating injury-related diagnoses by physicians: an analysis of 62,269 hospitalizations from a large hospital in Changsha, China.

Abstract

To assess the accuracy of injury-related hospitalization diagnoses by physicians in China. 62,269 hospitalizations between 2014 and 2016 at a large hospital in Changsha, China were assessed. We considered three types of diagnostic errors: under-reporting, lack of cause specificity, and misclassification across injury causes. Diagnosis and coding of diseases were ascertained by professional coders based on the tenth International Classification of Disease (ICD-10). Chi square tests examined the proportion difference across subgroups of patient demographics, injury intent, and injury cause. The 62,269 records included 1011 injury-induced hospitalizations, but physicians' diagnoses only reported 405 (40%) of the 1011 hospitalizations as injury-related. The proportions of under-reporting, lack of cause specificity, and misclassification errors, respectively, were 50.5%, 7.9% and 1.5%. The proportion of diagnostic errors was relatively similar across patient sex, intent of injury, and cause of injury subgroups, but varied substantially across patient age groups. Physicians' diagnoses frequently omitted injury-induced hospitalizations. Such errors will impact injury research and policy-making when they are undetected and uncorrected.