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

Page
125
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125
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 125
Append ix I GENERAL COMPARISON OF ASSESSMENTS OF THE: RELIAB ILITY OF MEDICARE RECORDS MAINTAINED BY THE HEALTH CARE FINANCING ADMINISTRATION AND HOSPITAL DISCHARGE ABSTRACTS COMPILED BY PRIVATE ABSTRACT SERVICES WE IGHTED PERCENTS ~ Medic are Correct data source where a No record or discrepancy exists Data discrep- private IOM items ancy abstract abstract Either Neither Total . HCFA's Medicare records . Diagnoses Four-digit 57.2 2.3 35.7 0.2 4.6 100.0 Three-digit 61.9 1. 9 31.6 0.2 4.4 100.0 All procedures 78. 9 1. 7 17.3 0.4 1. 7 100.0 Procedures coded 56.6 5.2 34.7 2.3 1.2 100.0 No procedures coded 89. 7 - 8.9 1.4 - 100.0 Private abstract service Medicare records Diagnoses Four-digit 64.4 1. 6 23. 3 0. 3 10.4 100. 0 Three-digit 73.9 0.9 15.2 0.2 9.8 100.0 - All procedures 72.5 2.6 7. 7 0. 1 17. 1 100.0 Procedures coded 64.8 3.9 9.1 0.2 22.Q 100.0 No procedures - coded 86.9 - 4. 9 - 8.2 100.0 Private abstract service Medicare Medicaid records - Diagnoses Four-digit 65.2 1.6 22.2 0.2 10. 7 100. 0 Three-digit 74.0 0. 9 14.8 0.2 10.0 100.0 All procedures 73.2 2.5 7.8 0.2 16.3 100.0 Procedures coded 66.0 3.8 9.3 0.2 20.7 100.0 No procedures coded 86. 7 - 5.3 0. 1 8.0 100.0 :125

OCR for page 126

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