Date of Award

January 2011

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

John M. Leventhal

Subject Area(s)

Medicine

Abstract

THE ACCURACY OF CODING INJURIES DUE TO CHILD PHYSICAL ABUSE. Jocelyn C. Ronda, John M. Leventhal. Department of Pediatrics, Yale University, School of Medicine, New Haven, CT.

Child physical abuse remains a serious health concern for children in the United States. In order to protect children from suffering additional injury there is a continued need for the study of child abuse. Hospitals routinely collect information about hospitalized victims of child abuse in hospital discharge database systems (HDDSs). In the United States, hospital coders categorize the illnesses and injuries of all hospitalized patients in HDDSs using the International Classifications of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes. An increasing number of studies have recognized the potential benefits of utilizing data from HDDSs to investigate child abuse. The accuracy of ICD-9-CM codes for child physical abuse, however, has not been extensively examined. Therefore, the aim of the present study is to evaluate the accuracy of ICD-9-CM codes for child physical abuse. The hypothesis is that ICD-9-CM codes for child physical abuse will have high accuracy for identifying cases of physical abuse in the Yale New Haven Hospital (YNHH) discharge database from January 1, 2007 through December 31, 2009. In this study, the decisions made in cases of suspected physical abuse by child abuse experts about the likelihood of physical abuse were compared to the codes assigned to the suspected victims in the YNHH discharge database. The results showed an accuracy, sensitivity, and specificity of ICD-9-CM codes for child physical abuse of 91.4% (CI 83.7% to 95.8%), 76.3 % (CI 59.4% to 88.0%), and 100% (CI 93.2% to 100%), respectively. ICD-9-CM codes for child physical abuse have a fairly high degree of accuracy for identifying victims of child physical abuse.

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