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

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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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Appendix A BIBLIOGRAPHY Eighth Revision of International Classification of Diseases, Adpated ~ , U.S. Department of Health Education, and Welfare, Social Security Administration, Pubn. No. 23-72, undated. Goodman, R. and Kish, L., "Controlled Selection - A Technique in Probability Sampling," Journal of the American Statistical Associa- tion, 45 (September 19505 350-72. Hess, Irene, Riedel, Donald C., and Fitzpatrick, Thomas B., Prob- ability Sampling of Hospitals and Patients, 2nd ed. (Ann Arbor: Health Administration Press, 1975~. Institute of Medicine, Reliability of Hospital Discharge Abstracts (Washington, D. C.: National Academy of Sciences, February 1977~. Medicare Hospital Manual, U.S. Department of Health, Education, and Welfare, HIM Pubn. 10-~6-66), Reprint, August 1975. Mill, Donald, Fetter, Robert B., Riedel, Donald C., Averill, Richard, "AUTOGRP: An Interactive Computer System for the Analysis of Health Care Data," Medical Care 14 (July 1976~: 603-615. Uniform Hospital Abstract: Minimum Basic Data Set. A Report to the U.S. National Committee on Vital and Health Statistics, Series 4, . . .. .. . . .. Number 14, December 1972. U.S. Department of Commerce, Bureau of the Census, The Current Pop- ulation Survey Reinterview Program: Some Notes and Discussion, Technical Paper No. 6 Washington, D. C.: U.S. Government Printing Office, 1963~. U.S. Department of Health, Education, and Welfare, Office of the Assistant Secretary for Health, Office of Professional Standards Review, Program Evaluation Plan: Professional Review Organizations, Martin A. Baum et al. (22 September 1975~. 71

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