Qual Saf Health Care doi:10.1136/qshc.2009.034306
  • Original research

Validation of Hospital Administrative Dataset for adverse event screening

  1. Walter Sermeus1
  1. 1Center for Health Services and Nursing Research, University Hospital of Liège, Liège, Belgium
  2. 2Department of Medico-Economic Information, University Hospital of Liège, Liège, Belgium
  • Accepted 19 December 2009
  • Published Online First 27 April 2010


Objective To assess whether the Belgian Hospital Discharge Dataset (B-HDDS) is a valid source for the detection of adverse events in acute hospitals.

Design, setting and participants Retrospective review of 1515 patient records in eight acute Belgian hospitals for the year 2005.

Main outcome measures Predictive value of the B-HDDS and medical record reviews and degree of correspondence between the B-HDDS and medical record reviews for five indicators: pressure ulcer, postoperative pulmonary embolism or deep vein thrombosis, postoperative sepsis, ventilator-associated pneumonia and postoperative wound infection.

Results Postoperative wound infection received the highest positive predictive value (62.3%), whereas postoperative sepsis and ventilator-associated pneumonia were rated as only 44.2% and 29.9% respectively. Excluding present on admission from the screening substantially decreased the positive predictive value of pressure ulcer from 74.5% to 54.3%, as pressure ulcers present on admission were responsible for more B-HDDS-medical record mismatches than any other indicator. Over half (56.8%) of false-positive cases for postoperative sepsis were due to a lack of specificity of the ICD-9-CM code, whereas in 58.6% of false-positive cases for ventilator-associated pneumonia, clinical criteria appeared to be too stringent.

Conclusions The B-HDDS has the potential to accurately detect some but not all adverse events. Adding a code ‘present on admission’ and improving the ICD-9-CM codes might already partially improve the correspondence between the B-HDDS and the medical record review.


  • SV and JJ both contributed equally to this study.

  • Funding The study was funded and contracted by the Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium under grant agreement 2006-21.

  • Competing interests None.

  • Ethical approval The study was approved by the ethics committee and the medical board of each hospital. Informed consent was obtained from all patients.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Free sample

This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of BMJ Quality & Safety.
View free sample issue >>

Email alerts

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.


Navigate This Article