Measuring Pneumonia-Related Mortality Using Administrative Data: Coding and Consequences
Authors: Scott A. Flanders, Sanjay Saint
Journal: Annals of Internal Medicine (2014)

Editorials18 March 2014Measuring Pneumonia-Related Mortality Using Administrative Data: Coding and ConsequencesScott A. Flanders, MD and Sanjay Saint, MD, MPHScott A. Flanders, MDFrom University of Michigan Medical School, Ann Arbor, Michigan; and Veterans Affairs Ann Arbor Healthcare System and University of Michigan Medical School, Ann Arbor, Michigan.Search for more papers by this author and Sanjay Saint, MD, MPHFrom University of Michigan Medical School, Ann Arbor, Michigan; and Veterans Affairs Ann Arbor Healthcare System and University of Michigan Medical School, Ann Arbor, Michigan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-0199 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Errors, like straws, upon the surface flow;He who would search for pearls, must dive below.—John Dryden, All for Love (1677)Achieving the triple aim of health care—better health, higher quality, and lower costs—is changing the landscape at U.S. hospitals. One key change is financially incentivizing hospitals to deliver higher quality at lower cost. The Centers for Medicare & Medicaid Services (CMS) Hospital Value-Based Purchasing Program, for example, currently withholds 1% of diagnostic-related group payments from hospitals and redistributes that money as incentives to hospitals that perform well on various measures, such as patient satisfaction and clinical outcomes. Financial incentives have ...References1. Jha AK, Joynt KE, Orav EJ, Epstein AM. The long-term effect of premier pay for performance on patient outcomes. N Engl J Med. 2012;366:1606-15. [PMID: 22455751] CrossrefMedlineGoogle Scholar2. Lagu T, Lindenauer PK. Putting the public back in public reporting of health care quality. JAMA. 2010;304:1711-2. [PMID: 20959582] CrossrefMedlineGoogle Scholar3. Fung CH, Lim YW, Mattke S, Damberg C, Shekelle PG. Systematic review: the evidence that publishing patient care performance data improves quality of care. Ann Intern Med. 2008;148:111-23. [PMID: 18195336] LinkGoogle Scholar4. Hayward RA, Kent DM. 6 EZ steps to improving your performance: (or how to make P4P pay 4U!). JAMA. 2008;300:255-6. [PMID: 18632535] CrossrefMedlineGoogle Scholar5. Brar NK, Niederman MS. Management of community-acquired pneumonia: a review and update. Ther Adv Respir Dis. 2011;5:61-78. [PMID: 20935033] CrossrefMedlineGoogle Scholar6. Agency for Healthcare Research and Quality. National Quality Measures Clearinghouse Web site. Accessed at www.qualitymeasures.ahrq.gov/browse/by-topic-detail.aspx?id=22511&ct=1 on 22 January 2014. Google Scholar7. Rothberg MB, Pekow PS, Priya A, Lindenauer PK. Variation in diagnostic coding of patients with pneumonia and its association with hospital risk-standardized mortality rates. A cross-sectional analysis. Ann Intern Med. 2014;160:380-8. LinkGoogle Scholar8. Meddings J, Saint S, McMahon LF. Hospital-acquired catheter-associated urinary tract infection: documentation and coding issues may reduce financial impact of Medicare's new payment policy. Infect Control Hosp Epidemiol. 2010;31:627-33. [PMID: 20426577] CrossrefMedlineGoogle Scholar9. Meddings JA, Reichert H, Hofer T, McMahon LF. Hospital report cards for hospital-acquired pressure ulcers: how good are the grades? Ann Intern Med. 2013;159:505-13. [PMID: 24126644] LinkGoogle Scholar10. Wachter RM, Flanders SA, Fee C, Pronovost PJ. Public reporting of antibiotic timing in patients with pneumonia: lessons from a flawed performance measure. Ann Intern Med. 2008;149:29-32. [PMID: 18591635] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Michigan Medical School, Ann Arbor, Michigan; and Veterans Affairs Ann Arbor Healthcare System and University of Michigan Medical School, Ann Arbor, Michigan.Disclaimer: The views expressed in this editorial are those of the authors and do not necessarily reflect the position or policy of the U.S. Department of Veterans Affairs.Acknowledgment: The authors thank Steven J. Bernstein, MD, MPH, University of Michigan, for providing comments on an earlier version of the editorial and Latoya Kuhn, MPH, for assistance with preparation of the manuscript.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0199.Corresponding Author: Scott A. Flanders, MD, 1500 East Medical Center Drive, 3119 Taubman Center, Ann Arbor, MI 48109; e-mail, [email protected]edu.Current Author Addresses: Dr. Flanders: 1500 East Medical Center Drive, 3119 Taubman Center, Ann Arbor, MI 48109.Dr. Saint: North Campus Research Complex, 2800 Plymouth Road, Building 16, Room 430W, University of Michigan, Ann Arbor, MI 48109-2800. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoVariation in Diagnostic Coding of Patients With Pneumonia and Its Association With Hospital Risk-Standardized Mortality Rates Michael B. Rothberg , Penelope S. Pekow , Aruna Priya , and Peter K. Lindenauer Variation in Diagnostic Coding of Patients With Pneumonia and Its Association With Hospital Risk-Standardized Mortality Rates Michael B. Rothberg , Penelope S. Pekow , Aruna Priya , and Peter K. Lindenauer Metrics 18 March 2014Volume 160, Issue 6Page: 430-431KeywordsDeath ratesMedicareMotivationPneumoniaResearch designResearch quality assessmentRespiratory failureSepsis ePublished: 18 March 2014 Issue Published: 18 March 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...