Accuracy of Hospital Discharge Codes in Medicare Claims for Knee and Hip Replacement Patients.
Med Care
; 58(5): 491-495, 2020 05.
Article
en En
| MEDLINE
| ID: mdl-31914103
ABSTRACT
BACKGROUND:
Despite the importance of the hospital discharge destination field ("discharge code" hereafter) for research and payment reform, its accuracy is not well established.OBJECTIVES:
The aim of this study was to examine the accuracy of discharge codes in Medicare claims. DATA SOURCES 2012-2015 Medicare claims of knee and hip replacement patients. RESEARCHDESIGN:
We identified patients' discharge location in claims and compared it with the discharge code. We also used a mixed-effects logistic regression to examine the association of patient and hospital characteristics with discharge code accuracy.RESULTS:
Approximately 9% of discharge codes were inaccurate. Long-term care hospital discharge codes had the lowest accuracy rate (41%), followed by acute care transfers (72%), inpatient rehabilitation facility (80%), and home discharges (83%). Most misclassifications occurred within 2 broad groups of postacute care settings home-based and institutional care. The odds of inaccurate discharge codes were higher for Medicaid-enrolled patients and safety-net and low-volume hospitals.CONCLUSIONS:
Inaccurate hospital discharge coding may have introduced bias in studies relying on these codes (eg, evaluations of Medicare bundled payment models). Inaccuracy was more common among Medicaid-enrolled patients and safety-net and low-volume hospitals, suggesting more potential bias in existing study findings pertaining to these patients and hospitals.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Alta del Paciente
/
Medicare
/
Artroplastia de Reemplazo de Cadera
/
Artroplastia de Reemplazo de Rodilla
/
Codificación Clínica
Tipo de estudio:
Prognostic_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Med Care
Año:
2020
Tipo del documento:
Article