The impact of three discharge coding methods on the accuracy of diagnostic coding and hospital reimbursement for inpatient medical care

Coding of diagnoses is important for patient care, hospital management and research. However coding accuracy is often poor and may reflect methods of coding. This study investigates the impact of three alternative coding methods on the inaccuracy of diagnosis codes and hospital reimbursement. [...]


Results

107 consecutive patient discharges were analysed. Inaccuracy of diagnosis codes

was highest when a coder used the discharge summary alone, and decreased

significantly when the coder used the case notes (70% vs 58% respectively, p <

0.0001) or coded from the discharge summary with medical support (70% vs 60%

respectively, p < 0.0001). When compared with the gold standard, the percentage

of incorrect HRGs was 42% for discharge summary alone, 31% for coding with case

notes, and 35% for coding with medical support. The three coding methods

resulted in an annual estimated loss of hospital remuneration of between £1.8 M

and £16.5 M [...] (International Journal of Medical Informatics).


DOI: 10.1016/j.ijmedinf.2018.03.015