Coding response to a case-mix measurement system based on multiple diagnoses

Health Services Research
Colin Preyra

Abstract

To examine the hospital coding response to a payment model using a case-mix measurement system based on multiple diagnoses and the resulting impact on a hospital cost model. Financial, clinical, and supplementary data for all Ontario short stay hospitals from years 1997 to 2002. Disaggregated trends in hospital case-mix growth are examined for five years following the adoption of an inpatient classification system making extensive use of combinations of secondary diagnoses. Hospital case mix is decomposed into base and complexity components. The longitudinal effects of coding variation on a standard hospital payment model are examined in terms of payment accuracy and impact on adjustment factors. Introduction of the refined case-mix system provided incentives for hospitals to increase reporting of secondary diagnoses and resulted in growth in highest complexity cases that were not matched by increased resource use over time. Despite a pronounced coding response on the part of hospitals, the increase in measured complexity and case mix did not reduce the unexplained variation in hospital unit cost nor did it reduce the reliance on the teaching adjustment factor, a potential proxy for case mix. The main implication was changes in...Continue Reading

References

Jan 1, 1989·Health Affairs·B Steinwald, L A Dummit
Feb 11, 1988·The New England Journal of Medicine·D C HsiaR P Kusserow
Feb 12, 1998·Annals of Internal Medicine·L I Iezzoni
Nov 25, 2003·International Journal of Health Care Finance and Economics·W J Lynk

❮ Previous
Next ❯

Citations

Dec 26, 2006·Health Care Management Science·Jason M Sutherland, Colin Preyra
Apr 21, 2010·Health Care Management Science·Jason M SutherlandJeff Hatcher
Jun 28, 2011·BMC Health Services Research·Jason M SutherlandR Trafford Crump
Jun 12, 2012·BMC Health Services Research·Robin L WalkerHude Quan
Mar 3, 2009·Health Policy·Jason M Sutherland, Olafr Steinum
Oct 24, 2007·Health Policy·Jason Murray Sutherland, Jan Walker
Nov 19, 2011·Health Services Research·L Elizabeth GoldmanAndrew Bindman
Nov 19, 2011·Health Services Research·Gavin WardleG Ross Baker
Aug 20, 2015·The International Journal of Health Planning and Management·Limei JingYuehong Zhuang
Jan 28, 2006·Health Policy·Jason M Sutherland, Chas K Botz
Oct 9, 2012·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M E A de KrakerH Grundmann
Feb 25, 2017·Journal of the American Heart Association·Maame Yaa A B YiadomAlan B Storrow
Sep 21, 2013·The Journal of Bone and Joint Surgery. American Volume·Benjamin J MillerPeter Cram
Mar 8, 2019·Revista de salud pública·Katiuska Reynaldos-GrandónYerko Molina-Muñoz
Feb 23, 2010·The Medical Journal of Australia·Antony Nocera

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Health Care Management Science
Reinhard BussePeter C Smith
Journal of Health Economics
Elaine Silverman, Jonathan Skinner
Journal of Health Economics
G M CarterD A Relles
CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
Wayne Kondro
© 2022 Meta ULC. All rights reserved