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Rights & Permissions Free Resources Display this book on your site! Related Titles From Cancer Patient to Cancer Survivor: Lost in Transition Eliminating Health Disparities: Measurement and Data Needs Other Related Titles Reliability of Medicare Hospital Discharge Records: Report of a Study (1977) Institute of Medicine (IOM) Web Search Builder Use this book's key terms to search within this book, across our collection, or across the Web. Skim This Chapter Skim this chapter and use this chapter's key terms to search within this book. Reference Finder Paste in your own text to find books that relate to your topic. Page 115 Page 115 Front Matter (R1-R6) Table of Contents (R7-R8) Foreword (R9-R10) Introduction (1-4) Study Methods (5-22) Analysis (23-60) Summary and Recommendations (61-70) Appendix A Bibliography (71-72) Appendix B Sample Letter to Hospital Administrators (73-74) Appendix C Diagnostic Codes Included as Components of the Sample of Medicare Records (75-84) Appendix D IOM Re-abstracting Form, General Instructions for Field Team, and Specific Instructions for IOM Re-abstracting Form (85-104) Appendix E Informal Checklist (105-106) Appendix F Reliability of Field Work (107-114) Appendix G Percent of Abstracts with no Discrepancy for each Diagnosis Included as a Component of the Sample of Medicare Records (115-120) Appendix H Net and Gross Difference Rates in Designation of Principal Diagnosis (Based on Four-Digit Comparisons of Specific Diagnosis) (121-124) Appendix I General Comparison of Assessment of the Reliability of Medicare Records Maintained by the Health Care Financing Administration and Hospital Discharge Abstracts Compiled by Private Abstract Services (125-126) Appendix J Comparison of the Reliability of HCFA Medicare Records and Private Abstract Service Medicare Abstracts for Selected Diagnoses Common to both Studies (127-128) Appendix K Standard Errors and Confidence Intervals for Statistics Based on Medicare Data (129-131) Appendix L Standard Errors and Confidence Intervals for Statistics Based on Data from Private Abstracting Services (132-133) Appendix M Selected Examples of Principal Procedures not Listed in CPT, as Determined by the IOM Field Team Members (134-134)

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OCR for page 115
Append ix G PERCENT OF ABSTRACTS WITH NO DISCREPANCY FOR EACH DIAGNOS IS INCLUDED AS A COMPONENT OF THE SAMPLE OF ~DICARE RECORDS* Diagno sis rel ated group Sub- groups 1. Ischemic heart disease except AMI Speci f ic . · . alagnos~ s Re sidual . . . alagnosls Cerebrovascul ar di seases Specific . . . alagnosls Residual . . . alagnosls 3. Fractures Spec i fic . . ~ .lagnosls Residual t ~ ~ a 1agnosls Chron ic i schem ic heart disease Subacute ischemic heart disease ~ satellite) Angina pec torts Asymptomat ic ischemic heart di sease Cerebrovascular di seases* None Fracture, neck of femur* Fracture of other and unspecified parts of femur satellite) 115 .. Percent with no discrep- ancy N - Total un- weighted 36.8 352 34.1 21.6 8 - 58.5 320 - 62.0 6

OCR for page 116
Diagno sis rel ated group - Di seases of the eye Spec i fic . . c .lagnosls Re sidual . . . alagnosls Sub- groups Frac ture o f skull, spine, and trunk Fracture of upper 1 imb Frac tures of lower 1 imb; excludes fractures of femur Catarac t* Inf lammatory di seases of the eye Other diseases and conditions 0 f the eye; excludes cataract and bl inane s s Ac ute myoc ard i al in f arc t ion Spec i fic . . . alagnosls Residual diagnosis 6. 116 Append ix G Total Perc ent wi th no discrep- weighted ancy un- N 79 .2 39 56.9 34 51.6 21 97 .4 242 60.8 75.3 57.6 Acute myoc ard ial in f arc t ion none Hernia of abdominal cavity Spec i fic . . . alagnosls Inguinal hernia without mention of ob struction 6 88.1 15 65.8 211 96.7 140

OCR for page 117
117 Append ix G . . D~agno S1S rel ated group Sub- groups Percent Total wi th no un- discrep- weighted ancy N . . . Residual . . d 1agnosls 7. Diabetes mellitus Spec if ic . . c ,lagnosls Residual . . . alagnosls Inguinal hernia with ob s true t ion ~ satel 1 ite) Other hernia o f abdominal cavity without mention of obstruction Other hernia o f re s idual abdom in al cavity with ob- s true t ion Diabete s* mel 1 itus none 8. Diseases of the prostate Spec i fic e @ ~ .lagnosls Residual . . . alagnosls 9. Pneumonia Spec i fic . . c .lagnosls Hyperplasia of prostate Pro statiti s and other disease s of the prostate Broncho pnelm~onia organism not specified and pneumonia organism and type not spec i f fed 85.9 14 74.7 57 81.4 5 49.7 224 87.1 229 75.9 17.6 8 2 86 .3 46 72.5 163

OCR for page 118
118 Append ix G Percent Total . . . . Diagnosis with no un- related Sub- discrep- weighted Residual Pneumonia, 100.0 3 diagnosis type and 44.2 9 organism 0.0 1 specified 100.0 1 0.0 1 10. Diseases of the gall bladder and bile duct Spec if ic Cholel ithiasis 66 .3 135 diagnosis and chole- 52.2 49 cystitis* Residual Other diseases 30.9 10 diagnosis of the gall bladder and bile duct 11. Miscellaneous diseases of the intestine and peritoneum Specific d iagnosi s Inte st in al oh struction without mention of hem ia 58.1 97 Residual Peritonitis, 64.9 5 diagnosis peritoneal 0 .0 1 adhesions, and 46 .8 102 other di seases or the inte st ine and per i toneum 12. Heart failure Spec i fic c diagnoses Congestive heart failure and left ventr icul ar failure 58.5 88

OCR for page 119
119 Append ix G Percent Total Diagno sis with no un- related Sub- discrep- weighted group groups ancy N Residual Acute heart 24. 4 diagnosis failure, undefined 5 13. Enteritis, diverticula, and functional disorders of intestine Specific . · . alagnosls Diverticulosis of intestine 86.5 138 Residual Noninfectious 37.5 2 diagnosis gastroentiritis and colitis, except ulcerative Chronic 79 .2 7 enteritis and ulcerative colitis Functional dis- orders of in- testine 14. Bronchitis 79.2 20 Specific Bronchitis 89.8 146 . . . alagnosls Residual . . dlagno sits None 15 . Mat ignant neoplasm of the respiratory system Specific Malignant neo- 79.9 141 diagnosis prams of bronchus and 1 ung

OCR for page 120
120 Append ix Diagno sis ret ated Sub- group - groups Percent Total wi th no un- di screp- weighted ancy -N Re sidual . . dlagnosls Primary malig- nant neoplasm ~ . or respiratory system except o f bronchus and 1 ung - 22.6 15.8 3 54.0 15 - 2 *Indicates specific or "target" diagnosis used in prior re-abstracting - study .

Representative terms from entire chapter:

diagno sis