Hepatitis vaccination in patients with hepatitis C: practice and validation of codes at a large veterans administration medical centre

Summary Background  Hepatitis vaccination is recommended in patients with chronic liver disease. Aim  To validate Current Procedural Terminology (CPT) codes and drug codes for hepatitis vaccination in administrative databases and determine vaccination rates in hepatitis C virus (HCV)‐infected patien...

Full description

Saved in:
Bibliographic Details
Published in:Alimentary pharmacology & therapeutics 2008-11, Vol.28 (9), p.1078-1087
Main Authors: HACHEM, C. Y., KRAMER, J. R., KANWAL, F., EL‐SERAG, H. B.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Digestive system
Gastroenterology. Liver. Pancreas. Abdomen
Hepatitis C virus
Hepatitis C, Chronic - immunology
Hepatitis, Viral, Human - immunology
Hepatitis, Viral, Human - prevention & control
Hospitals, Veterans
Human viral diseases
Humans
Immunization Programs - statistics & numerical data
Immunization Schedule
Infectious diseases
Medical Records Systems, Computerized
Medical sciences
Pharmacology. Drug treatments
Retrospective Studies
Statistics as Topic
United States
United States Department of Veterans Affairs
Vaccination
Viral diseases
Viral hepatitis
Viral Hepatitis Vaccines - administration & dosage
Viral Hepatitis Vaccines - immunology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary Background  Hepatitis vaccination is recommended in patients with chronic liver disease. Aim  To validate Current Procedural Terminology (CPT) codes and drug codes for hepatitis vaccination in administrative databases and determine vaccination rates in hepatitis C virus (HCV)‐infected patients in a single large Veterans Administration Medical Center. Methods  We calculated predictive values for hepatitis vaccination codes in a validation set of 168 patients. We then conducted a retrospective cohort study of 243 HCV‐infected patients to determine rates of hepatitis vaccination and serological testing. Results  The presence of CPT or drug codes for hepatitis A vaccine yielded a positive predictive value (PPV) and negative predictive value (NPV) of 93.2% and 94.0%. The presence of hepatitis B vaccine codes yielded a PPV of 98.0% and an NPV of 94.0%. Among patients diagnosed with HCV between 2000 and 2005, receipt of hepatitis vaccination was documented in approximately 8% overall and 7% in patients with cirrhosis. Half of the patients without hepatitis vaccinations were either not tested for immunity or had negative serology. Conclusions  Current Procedural Terminology or drug codes for hepatitis vaccinations in administrative data are highly predictive of the presence of vaccinations in medical records. Our data suggest that there is significant under‐utilization of vaccination in patients with HCV.
ISSN:0269-2813
1365-2036
DOI:10.1111/j.1365-2036.2008.03827.x