Diagnosis Summary and Coding of Obstetric Conditions in the Government Hospitals in Pattalung Province, The Effects of Audit and Feedback
Worapin Wittayawarawat MD*, Tippawan Liabsuetrakul MD, PhD*, Sathana Tassee MD*
Affiliation : * Department of Obstetrics & Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla
Objective : Assess the effects of audit and feedback through a seminar on the obstetric summary and coding
system with respect to the International Classification of Diseases, Tenth Revision (ICD-10) and to determine
factors associated with the error of summary and coding audit.
Materials and Methods : The medical records of 1,629 and 1,337 women with obstetric conditions admitted to
one provincial and nine district hospitals in Pattalung Province, Southern Thailand, were evaluated before
and after a seminar, respectively.
Result: The error of coding audit among cases with normal conditions and those with abnormal conditions
after the seminar was reduced significantly from 40.7 to 13.0% and from 81.8% to 61.2%, respectively (p <
0.001). A seminar was a significant factor to reduce the errors of summary and coding. In contrast, the
incorrect diagnosis summary, abnormal obstetric conditions and the district hospital were significantly asso-
ciated with the increase of the coding errors.
Conclusion : The audit and feedback was moderately effective on summary and coding audit but the clinical
significance of error reduction in abnormal obstetric conditions was marginal, thus intensive intervention,
evaluation, and monitoring are necessary.
Keywords : Summary audit, Coding audit, ICD-10, Obstetric, Audit and feedback, Southern Thailand
