Evaluation of Administrative Data for Identifying Maternal Opioid Use at Delivery in Florida
© 2023. The Author(s)..
OBJECTIVES: Studies have shown significant increases in the prevalence of maternal opioid use. Most prevalence estimates are based on unverified ICD-10-CM diagnoses. This study determined the accuracy of ICD-10-CM opioid-related diagnosis codes documented during delivery and examined potential associations between maternal/hospital characteristics and diagnosis with an opioid-related code.
METHODS: To identify people with prenatal opioid use, we identified a sample of infants born during 2017-2018 in Florida with a NAS related diagnosis code (P96.1) and confirmatory NAS characteristics (N = 460). Delivery records were scanned for opioid-related diagnoses and prenatal opioid use was confirmed through record review. The accuracy of each opioid-related code was measured using positive predictive value (PPV) and sensitivity. Modified Poisson regression was used to calculate adjusted relative risks (aRR) and 95% confidence intervals (CI).
RESULTS: We found the PPV was nearly 100% for all ICD-10-CM opioid-related codes (98.5-100%) and the sensitivity was 65.9%. Non-Hispanic Black mothers were 1.8 times more likely than non-Hispanic white mothers to have a missed opioid-related diagnosis at delivery (aRR:1.80, CI 1.14-2.84). Mothers who delivered at a teaching status hospital were less likely to have a missed opioid-related diagnosis (p < 0.05).
CONCLUSIONS FOR PRACTICE: We observed high accuracy of maternal opioid-related diagnosis codes at delivery. However, our findings suggest that over 30% of mothers with opioid use may not be diagnosed with an opioid-related code at delivery, although their infant had a confirmed NAS diagnosis. This study provides information on the utility and accuracy of ICD-10-CM opioid-related codes at delivery among mothers of infants with NAS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Maternal and child health journal - 27(2023), Suppl 1 vom: 11. Dez., Seite 44-51 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Elmore, Amanda L [VerfasserIn] |
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| Links: |
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| Themen: |
Accuracy |
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| Anmerkungen: |
Date Completed 04.12.2023 Date Revised 26.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10995-023-03669-6 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM357024095 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a OBJECTIVES: Studies have shown significant increases in the prevalence of maternal opioid use. Most prevalence estimates are based on unverified ICD-10-CM diagnoses. This study determined the accuracy of ICD-10-CM opioid-related diagnosis codes documented during delivery and examined potential associations between maternal/hospital characteristics and diagnosis with an opioid-related code | ||
| 520 | |a METHODS: To identify people with prenatal opioid use, we identified a sample of infants born during 2017-2018 in Florida with a NAS related diagnosis code (P96.1) and confirmatory NAS characteristics (N = 460). Delivery records were scanned for opioid-related diagnoses and prenatal opioid use was confirmed through record review. The accuracy of each opioid-related code was measured using positive predictive value (PPV) and sensitivity. Modified Poisson regression was used to calculate adjusted relative risks (aRR) and 95% confidence intervals (CI) | ||
| 520 | |a RESULTS: We found the PPV was nearly 100% for all ICD-10-CM opioid-related codes (98.5-100%) and the sensitivity was 65.9%. Non-Hispanic Black mothers were 1.8 times more likely than non-Hispanic white mothers to have a missed opioid-related diagnosis at delivery (aRR:1.80, CI 1.14-2.84). Mothers who delivered at a teaching status hospital were less likely to have a missed opioid-related diagnosis (p < 0.05) | ||
| 520 | |a CONCLUSIONS FOR PRACTICE: We observed high accuracy of maternal opioid-related diagnosis codes at delivery. However, our findings suggest that over 30% of mothers with opioid use may not be diagnosed with an opioid-related code at delivery, although their infant had a confirmed NAS diagnosis. This study provides information on the utility and accuracy of ICD-10-CM opioid-related codes at delivery among mothers of infants with NAS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Accuracy | |
| 650 | 4 | |a Maternal | |
| 650 | 4 | |a Neonatal abstinence syndrome | |
| 650 | 4 | |a Opioid | |
| 650 | 4 | |a Sensitivity | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 700 | 1 | |a Salemi, Jason L |e verfasserin |4 aut | |
| 700 | 1 | |a Kirby, Russell S |e verfasserin |4 aut | |
| 700 | 1 | |a Sappenfield, William M |e verfasserin |4 aut | |
| 700 | 1 | |a Lowry, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Dixon, Ashley |e verfasserin |4 aut | |
| 700 | 1 | |a Lake-Burger, Heather |e verfasserin |4 aut | |
| 700 | 1 | |a Tanner, Jean Paul |e verfasserin |4 aut | |
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