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INSTITUTE OF MEDIC INK RELIABILITY OF MEDICARE HOSPITAL DISCHARGE RECORDS Final Report November 1977 Supported by U. S. Department of Health, Education, and Wel fare Contract No. SSA 600-76-0159 Nat tonal Ac ademy o f Sc ienc es Wa shing ton, D . C . _ R R A T IJ M See page ix -- last sentence should read: The committee hopes that this report may be reviewed as one step toward the eventual creation of such a system.

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NOTICE The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the Councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the Committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee con- sisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. Supported by U.S. Department of Health, No. 600-76-0159. Education, and Welfare Contract The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 - ~ charter responsibility to be an advisor to the Federal and its own initiative in identifying issues of medical care, Congressional charter Government, ~ ~~ research, and education. Publication IOM-77-05

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NATIONAL ACADEMY OF SCIENCES 2101 CONSTITUTION AVENUE WASHINGTON, D. C. 20418 I NSTITUTE OF M EDICI N E OFFICE OF THE PRESIDENT Clifton R. Gaus, Sc e D. Acting Associate Administrator for Policy, Planning, and Research Room 5082 DREW Switzer Building 330 C Street, S.W. Washington, D.C. 20201 Dear Dr. Gaus: November 28, 1977 I am pleased to present to the Health Care Financing Administration the final report of the study of the reliability of Medicare hospital discharge records conducted by the Institute of Medicine, National Academy of Sciences, under contract no. 600-76-0159. The study was intended to assess the reliability of ~nformnt;on H".crr;hin~ hnc:T~;ta1 1~;1 ;~~ :~ ~_. ~~:~ __ A. _ . _ . .. . - . ... -v By rl~ulu~r~ ~~IleIlClarleS WnlCn IS obtained as a by-product of the Medicare administrative recordkeeping system. The purpose was to determine the usefulness of such information for evaluating the impact of Professional Standards Review Organizations; however, the results have broader implications for the collection and use of national health statistics. We will be happy to discuss the report in greater detail with you or members of your staff. Sincerely yours, ,~ (\ ~ C' .., . . in. ~ .. . . .. ....... /\ / - ; .~ David A. Hamburg, M.D. President Institute of Medicine Enclosure

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Institute of Medic ine Div i s ion o f Heal th Care Serv ice s RELIABILITY OF MEDICARE HOSPITAL DISCHARGE RECORDS TECHNICAL ADVI SORS Robert J. HAGGERTY, M. D., (Chairman), Roger I. Lee Professor of Public Health, Harvard School of Public Health, Boston, Massachusetts Faye BROWN, R. R.A., Director, Medical Information Service , St . Helena Hospital and Health Center, Deer Park, California Jacob J. FELDMAN, Ph.13., Associate Director for Analysis, National Center for Health Statistics, Hyattsville, Maryland Donald C. RIEDEL, Ph.~., Chairman of the Center for the Study of Health Services, Yale University, New [lay en, Connecticut Joseph STEINBERG, President, Survey Design, Inc ., Silver Spring, Mar y 1 and STAFF Linda K. DEMLO, Ph.D., Paul M. CAMPBELL, M. S. Sarah Spaght BROWN, M. P. H. Sandra H. MATTHEW S FIELD TEAM Division and Study Direc tar Judy HILL, R.R.A., Lynchburg, Virginia Maureen COLLINS, R. R.A., Buffalo, New York Barbara PUDER, R.R.A., St. Louis, Missouri Irene RENDEN, R. R.A., Columbia, Missouri v

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