Monitoring of clinical activities and performances by using international classifications ICD-10 and ICPC-2: Three years experience of the Kigali University Teaching Hospital, Rwanda

Measuring performances of health professionals and health facilities is a difficult task. However, with the appropriate information management tools, a lot of useful information can be collected from routine data registration activities. Situated in the capital of Rwanda, the Central Kigali University Teaching Hospital developed in January 2006 its electronic patient record using both ICD10 and ICPC2 codes for the structured registration of diseases and procedures. In order to enable synoptic data analysis, individual codes have been grouped into a set of 174 disease groups (KHIRI Pathology Group Set –KPGS). To assess the activities and performances of the different clinical departments, outcome data were analyzed following a number of essential criteria: the caseload, the LOS (length of stay) load and the in-hospital mortality load. A total number of 27784 patients were admitted during the study period. On the 27784 patients a total of respectively 30609 and 29447 diagnoses were recorded in ICPC2 and ICD10. The total of hospitalization days was 395256. 2759 patients died over the 3 years study period. Four ICPC classes covered more than 10% of the encodings each: A (general) 5649, D (digestive system) 6040, L (locomotors system) 3297 and R (respiratory system) counted for 4026 registrations. Comparable results could be obtained in the corresponding ICD classes A+B, K, M+S-T and J. Linking ICD10 and ICPC2 codes to global patient data clearly enables the physicians and the hospital management to produce comparable, standardized and internationally valuable evaluations of the hospital activities and trends. It also opens the perspective of fixing objective priorities in patient management and provides an interesting starting point for comparing health professionals’ clinical performances in a standardized way.