Do hospital E-codes consistently capture suicidal behaviour?

Chronic Dis Can. 2002 Fall;23(4):139-45.


Hospital separation data are used to study suicidal behaviour; however, there is little information about the appropriateness of these data for research and planning activities. The study purpose is to examine how consistently hospital separation E-code data reflect suicidal behaviours. Expert clinicians reviewed medical records of individuals who had a separation for self-poisoning to determine whether the self-poisoning was deliberate. Agreement among clinicians was evaluated and latent class analysis performed to derive a summary estimate of the prevalence of deliberate self-poisoning. This estimate was then compared to the prevalence of deliberate self-poisoning based on the external cause of injury (E-codes). Clinicians estimated the prevalence to be 63% higher than the E-code based prevalence. Much larger discrepancies were apparent among older age groups, those whose care was primarily medical in nature and those with a longer length of hospital stay. In acute care settings, self-poisonings among the elderly may not receive adequate attention and/or documentation. Estimating the prevalence of admissions for suicidal behaviour using hospital separation data is of questionable validity, particularly among older age groups.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Canada / epidemiology
  • Documentation / standards
  • Female
  • Hospital Planning
  • Humans
  • International Classification of Diseases*
  • Length of Stay
  • Male
  • Medical Records / classification*
  • Middle Aged
  • Patient Discharge / statistics & numerical data*
  • Poisoning / classification*
  • Poisoning / psychology
  • Prevalence
  • Suicide, Attempted / classification*
  • Suicide, Attempted / prevention & control