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Reliability of Medicare Hospital Discharge Records: Report of a Study (1977)
Institute of Medicine (IOM)

Page
121
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Page
121
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 121
Append ix H NET AND GROSS DIFFERENCE RATES IN DESIGNATION OF PRINCIPAL DLAGNOS IS ( BASED ON FOUR-DIGIT COMPARISONS OF SPECIFIC DIAGNOSES ) Percent of abstracts Net and gross with indicated dif ference rates principal diagnoses ~ times 1,000) ... . IOM Med ic are abstract record Net Gross Chron ic ischemic heart disease Other Total Chronic ischemic heart disease 3. ~ 1.5 5.3 Other 5.8 88.9 94. 7 Total 9. 6 90 .4 100.0 -43 .4 73 . 1 Cerebro- vascular d i sease s Other Total Cerebrovascul ar diseases 4.2 3.1 7.3 Other 1.1 91.6 92.7 Total 5.3 94. 7 100.0 19. 7 41.8 Fracture, neck of femur Other Total Fracture, neck of femur 1.5 0. ~ 2.3 Other 0.1 97.6 97.7 Total 1. 6 98 .4 100. 0 6. 7 9.3 121

OCR for page 122
122 Appendix H IOM Med ic are abstract record Net Gross Cataract Other Total Cataract 2.9 0.2 3.1 Other 0.0 96 .9 96 .9 Total 2.9 97.1 - 100.0 1.0 2.0 Ac ut e myo- cardial in fare Lion Ac ute myoc ard i al Other Total infarction 1. 7 1.1 2. Other 0.6 96.6 97.2 Total 2.3 97.7 100.0 5.8 16.5 Inguinal hernia without mention 0 f ob s truc- tion Other Total Inguinal hernia wi shout mention o f obstruction 1.3 0.2 1.5 Other 0 .0 98 .5 98 . 5 Total 1.3 98.7 100.0 1.3 2.0 Diabetes met 1 itus Other Total Diabetes mellitus 1.3 0.8 2.1 Other 1.1 96.8 97.9 Total 2.4 97.6 100.0 -3.2 19.0 Hyper- plasia of the pro state Other Total Hyperplasia of the prostate 2.0 0.4 2.4 Other 0.3 97.3 97.6 Total 2.3 97.7 100.0 1.4 6.5 ~ ,. ! ., .

OCR for page 123
123 Append ix H TOM Med ic are abstract record Net Gross Broncho- pneumonia- organ~ sm not spec i fled and pneumonia- organism and type not specified Other Total Bronchopneumonia- organ~ sm not specified and · ~ pne~onla-org and em and type not specified 2.2 1.4 3.6 Other 0.5 95.9 96.4 Total 2.7 97 .3 100.0 8.7 18. 7 Choleli- thiasi s/ chole- cystitis Other Total Cholelithiasis/ cholecystitis 1.3 0.9 2.2 Other 0.3 97.5 97.8 Total 1.6 98.4 100.0 6.0 11.9 Inte s t in al ob struction without mention of hernia Other Total Inte s t in al ob s true t ion without mention of hernia 0.5 0.5 1.0 Other 0.3 98.7 99.0 Total 0.8 99.2 100.0 2.1 7.7

OCR for page 124
124 Appendix H TOM Medicare abstract record Net Gross ~ , . _ Congestive heart failure and left ventricular failure Other Total Congestive heart failure and left ventricular failure 1.0 2.1 3.1 Other 0 . 7 96 .2 96 . 9 Total 1. 7 98 .3 100 .0 13 . 7 27 .4 Divert ic- ulosis of inte st ine Other To tat Diverticulosis of intestine 1.3 0. 7 2.0 Other 0.2 97.8 98.0 Total 1.5 98.5 100.0 4.8 8.7 Bronchitis Other Total Bronchitis 1.0 0.5 1.5 Other 0. 3 98 . 2 98 . 5 Total 1.3 98.7 100.0 2.1 8.0 Mat ignant neoplasm o f bronchus and lung Other Total Mal ignant neoplasm o f bronchus and lung 0 . 9 0 . 2 1 . 1 Other 0 .2 98 . 7 98 . 9 Total 1.1 98.9 100.0 -0.1 4.1

Representative terms from entire chapter:

abstract record