Evidence for the low recording of weight status and lifestyle risk factors in the Danish National Registry of Patients, 1999–2012

Mette Søgaard, Uffe Heide-Jørgensen, Mette Nørgaard, Søren P. Johnsen, Reimar W. Thomsen

To examine the prevalence of lifestyle diagnosis codes recorded in the Danish National Registry of Patients (DNRP). We identified all hospital contacts in Denmark 1999-2012 with a diagnosis of overweight, obesity, physical inactivity, current tobacco smoking, and/or excessive alcohol consumption. We computed the annual prevalence per 1000 hospital contacts of these diagnoses overall and by baseline characteristics. Among 56,665,048 hospital contacts, the overall prevalence of recording per 1000 hospital contacts was 4.87 for a diagnosis of obesity, 2.36 for overweight, 2.90 for smoking, 0.39 for excessive alcohol consumption, and 0.47 for physical inactivity. Between 1999 and 2012, marked increases were noted for the prevalence of recorded obesity (30-fold, from 0.26 to 8.02), smoking (26-fold, from 0.18 to 4.88), and overweight (14-fold, from 0.23 to 3.52). Diagnosis coding of excessive alcohol consumption and physical inactivity remained at a very low level. The prevalence of recorded lifestyle risk factors varied substantially according to geographical regions, type of hospital contact, patient age, sex and underlying disease. In 2012, the prevalence of codes for obesity were highest among patients with diabetes (15.64 per 1000), COPD (12.95 per 1000), and congestive heart failure (11.24 per 1000). Codes for smoking were prevalent among patients with COPD (14.11 per 1000), liver disease (12.68 per 1000), and peripheral vascular disease (8.52 per 1000). Despite increasing prevalence of adverse lifestyle risk factors recorded in the DNRP, the much higher prevalence of similar lifestyle risk factors in health surveys suggests that the completeness of coding in the DNRP remains poor.