Journal article
Uncommon combinations of ICD10-PCS or ICD-9-CM operative procedure codes account for most inpatient surgery at half of Texas hospitals
Journal of clinical anesthesia, Vol.41, pp.65-70
09/2017
DOI: 10.1016/j.jclinane.2017.06.002
PMID: 28802614
Abstract
Recently, there has been interest in activity-based cost accounting for inpatient surgical procedures to facilitate "value based" analyses. Research 10-20years ago, performed using data from 3 large teaching hospitals, found that activity-based cost accounting was practical and useful for modeling surgeons and subspecialties, but inaccurate for individual procedures. We hypothesized that these older results would apply to hundreds of hospitals, currently evaluable using administrative databases. Observational study. State of Texas hospital discharge abstract data for 1st quarter of 2016, 4th quarter of 2015, 1st quarter of 2015, and 4th quarter of 2014. Discharged from an acute care hospital in Texas with at least 1 major therapeutic ("operative") procedure. Counts of discharges for each procedure or combination of procedures, classified by ICD-10-PCS or ICD-9-CM. At the average hospital, most surgical discharges were for procedures performed at most once a month at the hospital (54%, 95% confidence interval [CI] 51% to 55%). At the average hospital, approximately 90% of procedures were performed at most once a month at the hospital (93%, CI 93% to 94%). The percentages were insensitive to the quarter of the year. The percentages were 3% to 6% greater with ICD-10-PCS than for the superseded ICD 9 CM. There are many different procedure codes, and many different combinations of codes, relative to the number of different hospital discharges. Since most procedures at most hospitals are performed no more than once a month, activity-based cost accounting with a sample size sufficient to be useful is impractical for the vast majority of procedures, in contrast to analysis by surgeon and/or subspecialty.
Details
- Title: Subtitle
- Uncommon combinations of ICD10-PCS or ICD-9-CM operative procedure codes account for most inpatient surgery at half of Texas hospitals
- Creators
- Liam O'Neill - Department of Health Behavior and Health Systems, School of Public Health, University of North Texas - Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States. Electronic address: liam.oneill@unthsc.eduFranklin Dexter - Department of Anesthesia, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States. Electronic address: Franklin-Dexter@UIowa.eduSae-Hwan Park - Department of Health Behavior and Health Systems, School of Public Health, University of North Texas - Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States. Electronic address: Sae-hwan.Park@live.unthsc.eduRichard H Epstein - Pain Management and Perioperative Medicine, University of Miami, Miller School of Medicine, 1400 NW 12th Avenue, Suite 3075, Miami, FL 33136, United States. Electronic address: repstein@med.miami.edu
- Resource Type
- Journal article
- Publication Details
- Journal of clinical anesthesia, Vol.41, pp.65-70
- Publisher
- United States
- DOI
- 10.1016/j.jclinane.2017.06.002
- PMID
- 28802614
- ISSN
- 0952-8180
- eISSN
- 1873-4529
- Language
- English
- Date published
- 09/2017
- Academic Unit
- Health Management and Policy; Anesthesia
- Record Identifier
- 9983806372502771
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