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Inpatient electronic prescribing data can be used to identify 'lost' discharge codes for diabetes
K Nirantharakumar1, T Marshall, K Hemming
1University of Birmingham, Birmingham, UK. k.nirantharan@bham.ac.uk
Diabetic Medicine : a Journal of the British Diabetic Association
|September 25, 2012
Summary
Accurate diabetes coding is crucial for hospital services. Using prescription data can identify missed diabetes discharge codes, improving coding accuracy and hospital payments.
Area of Science:
- Health Informatics
- Hospital Administration
- Diabetes Management
Background:
- Accurate discharge coding is vital for effective hospital diabetes service planning.
- Missed diagnostic codes can significantly impact hospital revenue and resource allocation.
Purpose of the Study:
- To estimate the frequency of missed diabetes discharge diagnostic codes.
- To assess the financial impact of these missed codes on hospital payments.
Main Methods:
- Linked Patient Administration System (PAS) data with Prescribing Information and Communication System (PICS) data.
- Defined diabetes using discharge codes and anti-diabetic medication records.
- Applied capture-recapture technique to estimate missed codes.
- Calculated Healthcare Resource Group (HRG) changes and payment impacts.
Main Results:
- 13.1% of admissions had a diabetes discharge code; 2.7% were estimated as missed.
- Prescription data identified 60% of missed diabetes cases.
- Correcting missed codes altered HRG and payment for 12.8% of affected admissions.
Conclusions:
- Electronic prescription data offers a straightforward method to correct missed diabetes discharge codes.
- Improving coding accuracy through prescription data enhances financial reimbursement and service planning.
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