Diagnosis summary and coding of obstetric conditions in the government hospitals in Pattalung Province, the effects of audit and feedback.

ABSTRACT

OBJECTIVE: Assess the effects of audit and feedback through a seminar on the obstetric summary and coding system with respect to the International Classification of Diseases, Tenth Revision (ICD-10) and to determine factors associated with the error of summary and coding audit. MATERIAL AND METHOD: The medical records of 1,629 and 1,337 women with obstetric conditions admitted to one provincial and nine district hospitals in Pattalung Province, Southern Thailand, were evaluated before and after a seminar, respectively. RESULT: The error of coding audit among cases with normal conditions and those with abnormal conditions after the seminar was reduced significantly from 40.7 to 13.0% and from 81.8% to 61.2%, respectively (p < 0.001). A seminar was a significant factor to reduce the errors of summary and coding. In contrast, the incorrect diagnosis summary, abnormal obstetric conditions and the district hospital were significantly associated with the increase of the coding errors. CONCLUSION: The audit and feedback was moderately effective on summary and coding audit but the clinical significance of error reduction in abnormal obstetric conditions was marginal, thus intensive intervention, evaluation, and monitoring are necessary.