Utilization of Disease Classification Systems among Health Information Professionals in ‘Selected Public Hospitals’ in Kiambu County, Kenya
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Date
2021
Authors
Maina, Duncan Mutongu
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Despite the globally acclaimed efficacy of the disease classification systems as a tool for
health planning, reporting and reimbursement, not enough emphasis is laid on the
quality of disease coding by the forerunners in the field. The starting point to sustaining
the quality of disease coding is establishing its utilization. The purpose of the study is to
establish the utilization of disease classification systems in Kiambu County, Kenya.
Specifically, the study aims to determine health professionals' factors, health system
factors and technological factors affecting utilization of disease classification systems
(DCS) in Public Hospitals. This study was conducted in Kiambu County, Kenya, with a
focus on public hospitals. Cross-sectional descriptive study design was used by
employing total population sampling of the target population. The population of interest
was the health records and information management professionals within the study area;
as well as the key opinion leaders. Complete enumeration and purposive sampling
designs were used to select the study participants, which included all 119 HRIOs in
Kiambu County. Data was collected using self-administered questionnaires and key
informant guides with the help of two research assistants. Data entry and analysis was
done using SPSS v22. Data analysis included both descriptive (frequencies, means,
percentages) and inferential statistics (Pearson chi-square with degrees of freedom),
with the alpha level of significance set at 5%. Out of the 112 respondents, 75 (67%)
indicated that the systems were utilized either frequently or always on average for the
functions studied. Clinical coding was done at various locations within the hospitals and
broadly depended on the layout of each facility. The study also found that greater age
(X2= 7.719; p=0.003), increase in length of coding experience (X2= 3.7; p=0.027), and
better DCS perception (X2= 9.74; p=0.00) were significantly associated with frequent
use of DCS utilization. Additionally, from the qualitative findings, resource allocation
for health, and consequently for DCS was inadequate; International coding guidelines
and policies were present as availed through the World Health Organization (WHO),
although local or national guidelines were missing. The study found sufficient evidence
to reject the null hypothesis that health professionals age, duration of disease
classification experience, and perception of DCS were not statistically significantly
associated with DCS utilization. The study concludes that, based on these findings,
coding experience, positive perception, health facility budget and availability of disease
classification technology were central to the success of utilization of DCS. The study
recommends 1) County Health Management Team (CHMT) and Sub-CHMT to increase
exploitation of the various uses of DCSs at facility level so as to improve the perception
of the staff; 2) The HRIOs to emphasize on importance of DCS technology in the health
facilities to increase utilization of the DCSs; and 3) The MOH should increase resource
allocation for health, and consequently for DCS at all levels: national and county.
Description
A research Thesis submitted in partial Fulfillment of the Requirements for the Award of the Degree of Master of Science (Health Information Management) in the School of Public Health and Applied Human Sciences of Kenyatta University, June 2020
Keywords
Utilization, Disease Classification Systems, Health Information Professionals, ‘Selected Public Hospitals’, Kiambu County, Kenya