Significant variation in colorectal surgery outcomes exists between different countries.
Better understanding of the sources of variable outcomes using administrative data requires alignment of differing clinical coding systems.
Dr Omar Faiz and colleagues mapped similar diagnoses and procedures across administrative coding systems used in different countries.
Administrative data were collected in a central database as part of the Global Comparators Project.
In order to unify these data, a systematic translation of diagnostic and procedural codes was undertaken.
|The 30-day mortality rate for colorectal surgery was 4%|
Codes for colorectal diagnoses, resections, operative complications and reoperative interventions were mapped across the respective national healthcare administrative coding systems.
Discharge data from 2006 to 2011 for patients who had undergone colorectal surgical resections were analyzed to generate risk-adjusted models for mortality, length of stay, readmissions and reoperations.
The research team collected 52,544 case records from 31 institutions in 5 countries.
Mapping of all the coding systems was achieved so that diagnosis and procedures from the participant countries could be compared.
The team used the aligned coding systems to develop risk-adjusted models.
The researchers found that the 30-day mortality rate for colorectal surgery was 4%, the 30-day readmission rate was 11%, the 28-day reoperation rate was 6%, and the mean length of stay was 14 days.
Dr Faiz's team concludes, "The linkage of international hospital administrative data that we developed enabled comparison of documented surgical outcomes between countries."
"This methodology may facilitate international benchmarking."