The impact of clinical vs administrative claims coding on hospital risk-adjusted outcomes
Clinical Cardiology Aug 30, 2018
O'Brien EC, et al. - Researchers compared comorbid condition and hospital risk-adjusted outcomes prevalence based on clinical registry vs administrative claims data. They linked clinical data from hospitalized CRUSADE non–ST-segment elevation myocardial infarction (NSTEMI) patients ≥65 years to Medicare claims. Findings demonstrated that, individual comorbid condition prevalence varied significantly in registries vs claims, but hospital-level outcomes were comparable. They noted that, for myocardial infarction and for diabetes, the degree of agreement between data sources for comorbid condition prevalence was 67.8% and 89.3%, respectively. Irrespective of data source, hospital ratings were found to be similar.
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