Evaluation of Administrative Data for Identifying Maternal Opioid Use at Delivery in Florida

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 associ...

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Bibliographic Details
Published in:Maternal and child health journal 2023-12, Vol.27 (Suppl 1), p.44-51
Main Authors: Elmore, Amanda L., Salemi, Jason L., Kirby, Russell S., Sappenfield, William M., Lowry, Joseph, Dixon, Ashley, Lake-Burger, Heather, Tanner, Jean Paul
Format: Article
Language:English
Subjects:
Accuracy
Analgesics, Opioid - adverse effects
Babies
Birth defects
Brief Report
Childrens health
Codes
Drug abuse in pregnancy
Ethnicity
Evaluation
Female
Florida - epidemiology
Gynecology
Health surveillance
Hispanic people
Hospitals
Humans
Infant
Infant, Newborn
Infants
Maternal & child health
Maternal and Child Health
Medical records
Medicine
Medicine & Public Health
Mothers
Narcotics
Neonatal abstinence syndrome
Neonatal Abstinence Syndrome - diagnosis
Opioid-Related Disorders - diagnosis
Opioid-Related Disorders - epidemiology
Pediatrics
Population Economics
Pregnancy
Prenatal care
Prescription drugs
Public Health
Sociology
Substance use disorder
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Summary: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 
ISSN:1092-7875
1573-6628
DOI:10.1007/s10995-023-03669-6