Hospital Coding of Dementia: Is it Accurate?

Author:

Cummings Elizabeth,Maher Roxanne1,Showell Christopher Morris2,Croft Toby3,Tolman Jane4,Vickers James5,Stirling Christine6,Robinson Andrew7,Turner Paul8

Affiliation:

1. Roxanne Maher BSC(HIM), Research Nurse - AusLong Study, Menzies Research Institute, University of Tasmania, Private Bag 23, Hobart TAS 7001 AUSTRALIA, Tel:+61 3 6226 7713

2. Christopher Morris Showell BAppSci(MLS), Research Fellow, eHealth Services Research Group, School of Computing and Information Systems, University of Tasmania, Private Bag 87, Hobart TAS 7001 AUSTRALIA, Tel:+61 3 62267200

3. Toby Croft BSc (Hons), PhD, Manager of Psychological Services, Royal Hobart Hospital, Liverpool Street, Hobart TAS 7000 AUSTRALIA, Tel:+61 3 6222 7840

4. Jane Tolman BA, Dip Ed, MEd, BSc, MBBS, FRACP, Director of Aged Care, Royal Hobart Hospital, Liverpool Street, Hobart TAS 7000 AUSTRALIA, Tel:+61 3 6222 7893

5. James Vickers BSc (Hons), PhD, DSc, Wicking Dementia Research Centre, University of Tasmania, Private Bag 34, Hobart TAS 7001 AUSTRALIA, Tel:+61 3 6226 2679

6. Christine Stirling BN, MPA PhD, Senior Lecturer, School of Nursing and Midwifery, University of Tasmania, Private Bag 135, Hobart TAS 7001 AUSTRALIA, Tel:+61 3 6226 4678

7. Andrew Robinson Dip App Sc (Nurs), MNSc, PhD, Professor of Aged Care Nursing School of Nursing and Midwifery, Co-Director, Wicking Dementia Research and Education Centre, University of Tasmania, Private Bag 121, Hobart TAS 7001 AUSTRALIA, Tel:+61 3 6226 4735

8. Paul Turner BA(Hons), MSC, PhD, Senior Research Fellow and Director eHealth Services Research, Group, School of Computing and Information Systems, University of Tasmania, Private Bag 87, Hobart TAS 7001 AUSTRALIA, Tel:+61 3 62266240

Abstract

This paper investigates the coding of dementia in the episode of care in a pilot study group ( N=48) post hospital discharge and the possible implications of under-coding. The assigned ICD-10-AM codes and Diagnosis Related Groups were reviewed. Results demonstrate under-coding of dementia and of cognitive deficits; poor correlation between admission diagnoses and dementia codes on separation; and changes in individual patients' cognitive status across forms and assessments in the same admission. The complexities of accurately coding dementias will impact upon planning for future treatments and service provision and will have a flow-on effect for patients, hospitals, and patient care in Australia.

Publisher

SAGE Publications

Subject

Health Policy,Leadership and Management

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