Person: Liu, Charles
Loading...
Email Address
AA Acceptance Date
Birth Date
Research Projects
Organizational Units
Job Title
Last Name
Liu
First Name
Charles
Name
Liu, Charles
Search Results
Now showing 1 - 2 of 2
Publication Brief Surgical Procedure Code Lists for Outcomes Measurement and Quality Improvement in Resource-Limited Settings(2016-05-17) Liu, CharlesConditions amenable to surgery represent a significant portion of the burden of disease worldwide, accounting for 10% of deaths and 14% of disability-adjusted life years lost. Today, however, over five billion people worldwide lack access to safe, timely, and affordable surgical care, and the outcomes experienced by surgical patients are least understood in low- and middle-income countries (LMICs). An important barrier to improving access to and quality of surgical care in resource-poor settings is the dearth of reliable data, due in part to the lack of a standardized system for classifying surgical procedures. The applicability of existing procedure coding systems in LMIC hospital settings is limited by their size, complexity, and cost of implementation. The coding of surgical procedures has been a particular challenge in Uganda and at Mbarara Regional Referral Hospital (MRRH), a 323-bed hospital and one of the country’s busiest surgical centers. A brief procedure code list could improve data collection for administrative, quality improvement, and research purposes at MRRH and in other resource-limited settings. Here, we describe the creation and validation of three abbreviated surgical procedure code lists at MRRH. We reviewed operating room logbooks to identify all surgical operations performed between January 1 and December 31, 2014. Based on the documented indication for surgery and procedure(s) performed, we assigned each operation up to four procedure codes from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), Volume 3. These codes were aggregated to generate procedure code lists. Each surgical procedure was assigned codes by one of two investigators working independently, and a random 20% of procedures were assigned codes by both investigators to evaluate inter-rater reliability. During the one-year study period, 6464 surgical procedures were performed at MRRH, to which we assigned 435 unique procedure codes. The Kappa statistic representing inter-rater reliability in assignment of codes was 0.7037. 111 procedure codes represented 90% of codes assigned, 180 represented 95%, and 278 represented 98%. These constituted short, intermediate-sized, and long code lists, respectively.Publication The How Project: understanding contextual challenges to global surgical care provision in low-resource settings(BMJ, 2016) Raykar, Nakul; Yorlets, Rachel; Liu, Charles; Goldman, Roberta; Greenberg, Sarah Louise Mather; Kotagal, Meera; Farmer, Paul; Meara, John; Roy, Nobhojit; Gillies, Rowan D