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ObjectivesThis study examined the validity of the principal diagnoses on discharge summaries and coding assessments.MethodsData were collected from the National Health Security Office (NHSO) of Thailand in 2015. In total, 118,971 medical records were audited. The sample was drawn from government hospitals and private hospitals covered by the Universal Coverage Scheme in Thailand. Hospitals and cases were selected using NHSO criteria. The validity of the principal diagnoses listed in the “Summary and Coding Assessment” forms was established by comparing data from the discharge summaries with data obtained from medical record reviews, and additionally, by comparing data from the coding assessments with data in the computerized ICD (the data base used for reimbursement-purposes).ResultsThe summary assessments had low sensitivities (7.3%–37.9%), high specificities (97.2%–99.8%), low positive predictive values (9.2%–60.7%), and high negative predictive values (95.9%–99.3%). The coding assessments had low sensitivities (31.1%–69.4%), high specificities (99.0%–99.9%), moderate positive predictive values (43.8%–89.0%), and high negative predictive values (97.3%–99.5%). The discharge summaries and codings often contained mistakes, particularly the categories “Endocrine, nutritional, and metabolic diseases”, “Symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified”, “Factors influencing health status and contact with health services”, and “Injury, poisoning, and certain other consequences of external causes”.ConclusionsThe validity of the principal diagnoses on the summary and coding assessment forms was found to be low. The training of physicians and coders must be strengthened to improve the validity of discharge summaries and codings.

HIV/AIDS and anxiety/depression are interlinked. HIV-infected patients suffering from depression may be at risk for poor adherence which may contribute to HIV disease progression. Additionally, an HIV diagnosis and/or using certain antiretroviral agents may trigger symptoms of anxiety/depression. The objective of the study was to assess the prevalence and factors associated with anxiety and depression in HIV-infected patients from the Thai National HIV Treatment Program. This cross-sectional study was performed from January 2012 to December 2012 in HIV-infected out-patients, aged ≥18 years, from three HIV referral centers. Symptoms of anxiety and depression were measured using the Thai-validated Hospital Anxiety and Depression Scale (HADS). A score of ≥11 was defined as having anxiety and depression. Associated factors were assessed by multivariate logistic regression. Totally 2023 (56% males) patients were enrolled. All patients received antiretroviral therapy (ART) for a mean duration of 7.7 years. Median CD4 was 495 cells/mm3. Ninety-five percent had HIV-RNA < 50 copies/ml. Thirty-three percent were currently on efavirenz (EFV)-based ART. The prevalence of anxiety and depression were 4.8% and 3.1%, respectively. About 1.3% had both anxiety and depression. In multivariate logistic models, the female sex [OR = 1.6(95%CI 1.1–2.3),p = .01], having adherence <90% [OR = 2.2(95%CI 1.5–3.4),p < .001], fair/poor quality of life (QOL) [OR = 7.2 (95%CI 3.6–14.2),p < .001] and EFV exposure [OR = 1.6(95%CI 1.1–2.3),p = .01], were independently associated with having anxiety or depression. Our findings demonstrated that prevalence of depression and anxiety was low amongst virally suppressed, long-term antiretroviral-treated HIV-infected individuals. Some key characteristics such as the female sex, poor adherence, poor/fair QOL and EFV exposure are associated with anxiety and depression. These factors can be used to distinguish who would need a more in-depth evaluation for these psychiatric disorders. [ABSTRACT FROM PUBLISHER]