Public Health and Nutrition

Biography

Biography: K. Goueslard

Abstract

Background : In France, in order to assess public health policy for the perinatal period, it is necessary to have available routinely produced indicators from the whole population. These indicators are used to compare French public health policy with that of other European countries. The PMSI’s administrative and medical data may provide valuable information for research; these data are simple and reliable. The study aims to measure the PMSI data’s quality for core indicators in perinatal health in three university health centres. Method: PMSI’s data were compared with medical files from 300 live births in 2012, after 22 weeks of amenorrhea, drawn at random from the CHUs in Dijon, Paris and Nancy. The variables were chosen based on the Europeristat project’s core and recommended indicators, as well as those of the Enquete Nationale Périnatale in 2010. The information gathered blindly from the medical files was compared with the PMSI data, the quality of which was estimated with the Positive Predictive Value (PPV) and the sensitivity. Results: The data about maternal age, parity and mode of delivery as well as the rates of premature births can be superimposed between the two sources. The PPV for epidural is 96.2% and 94.3% for perineal tears. Overall, maternal morbidity is underdocumented in the PMSI, so the PPV is 100.0% for pre-existing diabetes, 88.9% for gestational diabetes and 100.0% for high blood pressure with a rate of 9.0% in PMSI and 6.3% in the medical files. The PPV for bleeding during labour is 89.5%. Conclusion: To conclude, the PMSI’s data are seemingly becoming more and more reliable for two reasons: on one hand, the importance of these data for budgetary promotion in hospitals; on the other, the increasing use of this information for statistical and epidemiological purposes.