MONICA Manual, Part II, Section 2

	Medical Care Assessment Data INPATIENT MANAGEMENT OF ISCHAEMIC HEART DISEASE PROCEDURE REPORTING FORM Form: UD       Version: 1    5.4.1989	FOR MDC USE ONLY Seq.no: Received: Filed:

Please print carefully or type the requested information. Please complete all blanks in accordance with the instructions provided. Complete one form for each MONICA Reporting Unit for each year. If the data are not available for the Reporting Units, please complete the form for the smallest possible population, as indicated in item 4.

Instructions

The purpose of this form is to permit the monitoring of changes in the rates of selected diagnostic and therapeutic procedures used in the hospital management of coronary heart disease in the populations of MONICA Reporting Units. Ideally the information provided on this form and on forms UB: Inpatient Management of Ischaemic Heart Disease Reporting Form -Hospital Separations and UC: Inpatient Management of Ischaemic Heart Disease Reporting Form - Aggregate Bed Days will permit the computation of age- and sex-specific and age standardized rates for selected cardiac procedures within the age band 35-64 years.

In general the information will be derived from official hospital statistical systems, but where these do not exist useful information could be provided from registers of procedures or from selected departments of cardiology or cardiovascular surgery.

Whenever possible, tables should be provided for individual MONICA Reporting Units. This will be possible only if the unit records from which the data are obtained include a code for the usual residence of the patient which can be used to identify, with reasonable accuracy, the residents of specific MONICA Reporting Units.

When this is not possible for individual Reporting Units, tables should be provided for the smallest possible area within which the Reporting Unit(s) are located, for example, the full MONICA Centre or a defined Health Service Region for which population figures are also available. Where disaggregation even to this level is not possible, national data should be provided.

In all situations when data are being reported for defined areas other than individual Reporting Units, full explanation should be provided in the comments section of the form for the guidance of the MONICA Data Centre.

In some countries, statistics which systematically cover the populations of defined regions of the country as a whole are not available, but individual hospitals maintain statistical systems relating to their own admissions. MCCs to which this applies are encouraged to report data from these hospitals even if it is not possible to define precisely the population from which the admissions are derived. However a full description of the estimated coverage of the MONICA population in such data should be provided.

In particular this description should note changes from previous years which may affect the comparability and continuity of data. For example, the opening of a new hospital, department of cardiology of department or Cardiac Surgery in a neighbouring area that would affect the previous referral patterns. It should also be indicated whether the data for these hospitals is likely to cover populations greater or smaller than the individual Reporting Units or the MONICA Centre as a whole.

This form is to be completed once each year (together with forms UB: Inpatient Management of Ischaemic Heart Disease Reporting Form -Hospital Separations and UC: Inpatient Management of Ischaemic Heart Disease Reporting Form - Aggregate Bed Days) and reported to the MONICA Data Centre (MDC), so that it is received there by 31 October each year. The information should be provided for the calendar year immediately preceding the year of reporting the data. For example, the data for 1988 should be reported by 31 October 1989. Please inform the MDC if there is any difficulty in meeting this schedule.

The first year for which the data should be provided is 1980. The forms for the years 1980 - 1988 should be reported to the MDC by 31 October 1989.

This form is to be completed by the MCC Principal Investigator or by someone officially designated to perform this task.

General instructions for completing form

The general instructions of form UB: Inpatient Management of Ischaemic Heart Disease Reporting Form -Hospital Separations also apply for this form.

A completed form with error corrections is enclosed at the end of the specific instructions.

Specific instructions for each item

These instructions should be followed carefully when completing the indicated version of the Inpatient Management of Ischaemic Heart Disease Procedure Reporting Form. Please ensure that the instructions are for the version of the form being completed. Specific instructions are listed by item below:

Items 1-4

These items are identical with the corresponding items of form UB: Inpatient Management of Ischaemic Heart Disease Reporting Form -Hospital Separations, and the same specific instructions apply here.

Item 5

Code here the system used for coding procedures in the source from which the data provided in item 6 was extracted.

In most centres the International Classification of Procedures (WHO, 1978) associated with ICD-9 or the ICD9-CM classification of procedures are in use. However the exact codes used for the procedures specified on this reporting form may vary from MCC to MCC and even between hospitals within the same MCC area. For example, the International Classification of surgical procedures accompanying ICD- 9 does not specify coronary angioplasty as such and local codes may apply. There are also number of alternate codes for angiography and other operations on coronary arteries. MCCs should therefore check carefully with the relevant Health Authority and Medical Record coding staff to ensure that the right codes are selected when requesting the other tables of specified procedures.

Item 6

Age Strata

Whenever possible provide the data for the five year age strata indicated in the table. If this is not possible the next lowest level of disaggregation should be used. If no age stratification is possible, as appears to be the case for procedures in some MCCs, total figures should be provided. The table should be modified by hand to indicate the age groups being used and a description of the age groups provided in item 9.

Size of population

Print or type the best mid-year estimates of the counts of the indicated age and sex groups of the population indicted in item 4. This column can be left blank only if item 4 was coded 7. If the form concerns whole MONICA Reporting Unit, it is sufficient to write in the space: "Reported separately on POPULATION DEMOGRAPHIC REPORTING FORM". If the population counts are exactly the same as for form UB: Inpatient Management of Ischaemic Heart Disease Reporting Form -Hospital Separations, it is sufficient to write in the space: "Reported on Form UB".

Number of separations during which the specified procedures were performed

Count all separations during which a particular procedure was performed at least once ("separations" here mean both hospital discharges alive and deaths in hospital) in the indicated age and sex groups of the population indicated in item 4 during the calendar year being reported. Where more than one procedure field exists precedence should be given to coronary artery by-pass grafting (CABG), followed by percutaneous transluminal coronary angioplasty (PTCA), followed by coronary angiography.

Items 7 - 9

These items are identical with the corresponding items of form UB: Inpatient Management of Ischaemic Heart Disease Reporting Form -Hospital Separations, and the same specific instructions apply here.

An example of a completed form is given on the next page.