Quality of official medical statistics on myocardial infarction in Lithuania

Abstract

The aim of our study was to reveal the main reasons of myocardial infarction (AMI) prevalence index fluctuations in Lithuania’s districts. Methods. We conducted a cross-sectional study to assess AMI prevalence in Lithuania in 1992, in order to assess the clinical diagnosis and propose a way to improve diagnosis and official statistics. All validated hospital discharge forms and death certificates coded according to the ICD-9, 410-411 codes were used to get the data of all AMI patients (N=2988) in these districts (N=44). To evaluate AMI prevalence index fluctuations, we assessed the coronary heart disease (CHD) (ICD-9, 410-414 codes) diagnosis coding errors on the death certificates of Lithuania (N=15748), as well as in official statistical hospital discharge forms (N=896). To assess possible errors in the official statistics and to reveal clinical diagnostic errors, AMI register technique for events registration proposed by WHO and MONICA program were used in one Lithuanian region. Results. There were fluctuations of AMI prevalence in the hospital index between separate districts (80-100%). AMI diagnoses according ICD-9 coding errors made up 40.9% of the errors in total CHD in death certificates, and 28.5% of the errors in hospital discharge forms. The inaccurate registration of AMI events by residential areas increased the real AMI prevalence in hospital index by 7% in men and 13.5% in women population. [...].