Lunetta Philippe, Impinen Antti, Lounamaa Anne
National Public Health Institute, Injury Prevention Unit, Helsinki, Finland.
Scand J Public Health. 2008 Nov;36(8):870-4. doi: 10.1177/1403494808089565.
Hospital discharge data (HDD) represent one of the most valuable information sources for injury prevention and control.
To investigate external code of injury (E-code) underreporting in the Finnish National Hospital Discharge Register from 1 January 1987 to 31 December 2004.
HDD for discharges with an injury as the main diagnosis were extracted from the FNHDR. The selection was made using codes for nature of injury (1987-1995, ICD-9; 1996-2004, ICD-10). The proportion of injury discharges with a missing E-code was examined by sex, age, hospital districts, type of hospital, duration of hospitalization, and nature of injury.
In 432,549 (23.1%) of the recorded 1,868,519 discharges, an E-code was missing. The proportion of the discharges with a missing E-code varied among the above variables. During the period 1987-2004, the overall E-code underreporting decreased from 18.0% to 12.8%. The introduction of the ICD-10 in 1996 was followed by a dramatic increase (up to 57.5% of all discharges) in E-code underreporting.
More attention ought to be dedicated to teaching and periodic training on the use of E-codes. Educational activities should specifically target the medical doctors, who, in Finland, are responsible for assigning the E-codes.
医院出院数据（HDD）是伤害预防与控制最有价值的信息来源之一。
调查1987年1月1日至2004年12月31日芬兰国家医院出院登记册中伤害外部编码（E编码）的漏报情况。
从芬兰国家医院出院登记册中提取以伤害作为主要诊断的出院HDD。使用伤害性质编码进行选择（1987 - 1995年，国际疾病分类第九版；1996 - 2004年，国际疾病分类第十版）。按性别、年龄、医院行政区、医院类型、住院时长和伤害性质检查漏报E编码的伤害出院病例比例。
在记录的1,868,519例出院病例中，432,549例（23.1%）漏报了E编码。漏报E编码的出院病例比例在上述变量中有所不同。在1987 - 2004年期间,总体E编码漏报率从18.0%降至12.8%。1996年引入国际疾病分类第十版后，E编码漏报率急剧上升（高达所有出院病例的57.5%）。
应更加重视E编码使用方面的教学和定期培训。教育活动应特别针对芬兰负责指定E编码的医生。
