Reliability of Medicare Hospital Discharge Records Report of a Study (1977) / Chapter Skim
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Appendix F Reliability of Field Work
Appendix F Reliability of Field Work
Pages 107-114
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From page 107... ...
The consultant did not know which member of the field team had done the initial abstracting or whether any discrepancies had initially been detected. After completing the independent abstracting, the consultant reviewed the Medicare record (also used by the field team)
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From page 108... ...
The levels of agreement on the presence of additional diagnoses and principal procedure were quite high; however, there was considerably less agreement on principal diagnosis. The "no discrepancy" figures slightly under-estimate the data reliability, because they do not include those' cases where there was a discrepancy between the field team member and the consultant, but the consultant agreed with the re-abstractor's determination of correct data source.
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From page 109... ...
(Because of the small sample size, applying the basic weights from the total data set to the assessment abstracts would have produced serious distortions.) With this approach, 75.4 percent of the assessment abstracts represented the 15 specific diagnoses, while only 24.6 percent fell into the "all else" category (see Table 4, below)
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From page 110... ...
The assessment confirms the finding that reliability is lowest for chronic ischemic heart disease. Where both the field team and assessment data differed from that on the Medicare record but agreed with each other, the extent of agreement on reasons selected to explain discrepancies with the Medicare record was also examined.
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From page 111... ...
,, Chronic ischemic heart disease Cereb rovascul ar d isease Fracture, upper neck o f femur Cataract Acute myocardial infarc Lion Weighted per cent of the total number of discrepanc ies for each d iagno s i s 14.1 12.2 5.7 Unwe ight ed number 0 f abstracts with .
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From page 112... ...
The indication of whether additional diagnoses are present was reported with a high level of reliability. Some difficulty was encountered in conclusively determining which diagnosis or procedure should be regarded as "principal." The reliability of diagnostic data varied, depending on the level of coding refinement and the specific diagnosis.
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From page 113... ...
Where both the field team member and assessment consultant disagreed with the Medicare record, they general ly agreed on the reasons for about seventy-five percent of the discrepancies on principal diagnosis and for all the discrepancies with principal procedure . These findings should be tempered by the limitations of the assessment The sample size was very small.
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