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Reliability of Medicare Hospital Discharge Records: Report of a Study (1977)
Institute of Medicine (IOM)

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. "Appendix J Comparison of the Reliability of HCFA Medicare Records and Private Abstract Service Medicare Abstracts for Selected Diagnoses Common to both Studies." Reliability of Medicare Hospital Discharge Records: Report of a Study. Washington, DC: The National Academies Press, 1977.

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Page
127
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Page
127
Front Matter (R1-R6)
Table of Contents (R7-R8)
Foreword (R9-R10)
Introduction (1-4)
Study Methods (5-22)
Analysis (23-60)
Summary and Recommendations (61-70)
Appendix A Bibliography (71-72)
Appendix B Sample Letter to Hospital Administrators (73-74)
Appendix C Diagnostic Codes Included as Components of the Sample of Medicare Records (75-84)
Appendix D IOM Re-abstracting Form, General Instructions for Field Team, and Specific Instructions for IOM Re-abstracting Form (85-104)
Appendix E Informal Checklist (105-106)
Appendix F Reliability of Field Work (107-114)
Appendix G Percent of Abstracts with no Discrepancy for each Diagnosis Included as a Component of the Sample of Medicare Records (115-120)
Appendix H Net and Gross Difference Rates in Designation of Principal Diagnosis (Based on Four-Digit Comparisons of Specific Diagnosis) (121-124)
Appendix I General Comparison of Assessment of the Reliability of Medicare Records Maintained by the Health Care Financing Administration and Hospital Discharge Abstracts Compiled by Private Abstract Services (125-126)
Appendix J Comparison of the Reliability of HCFA Medicare Records and Private Abstract Service Medicare Abstracts for Selected Diagnoses Common to both Studies (127-128)
Appendix K Standard Errors and Confidence Intervals for Statistics Based on Medicare Data (129-131)
Appendix L Standard Errors and Confidence Intervals for Statistics Based on Data from Private Abstracting Services (132-133)
Appendix M Selected Examples of Principal Procedures not Listed in CPT, as Determined by the IOM Field Team Members (134-134)

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Append ix J COMPARISON OF THE RELIABILITY OF HCFA MEDICARE RECORDS AND PRIVATE ABSTRACT SERVICE MEDICARE ABSTRACTS FOR SELECTED DIAGNOSES COMMON TO BOTH STUDIES (SOURCE: IOM FIELD DATA) l Weighted percent Percent of of all abstracts abstracts with that each diag- no discrepancy nosis represents Private Private HCFA's service HCFA's service Medicare Medicare Medicare Medicare Diagnosis- ICDA-codes* records records records records . Chronic ischemic 412 . 0; 412 .9 36 . 8 27 . 9 9 . 8 8 . 6 ~ . . heart disease Cerebrovascular 430 . 0-430 .9 58 .5 79 .8 6.9 10.1 diseases Fracture, neck of femur 820.0-820.9 ( 820. 0-820 . 5; 820. 9) 70.5 81.0 2.0 3.7 Cataract 374.0-374.9 97.3 94.3 3.0 7.5 (374.0;374.1; 374.8;374.9) Acute myocardial 410.0-410.9 67.3 67.7 2.4 5.3 infarction (410. 0;410. 1; 410. 9) Inguinal hernia 550 96 . 7 87 . 9 1 . 3 2 .1 without mention of obstruction Diabetes mel1itus 250 . 0-250 . 9 49 . 7 60 . 5 2. 5 2 . 9 (250.0;250.9) Cholelithiasis/ 574.0-574.9; 62.8 74.8 2.0 3.5 cholecystitits 575 *Where diagnostic codes for sampling private abstract service records differed from those in the study of Medicare records, they are in parentheses. 127

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