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Evaluation of the quality of Present-on-admission coding

This study evaluates the quality of Present-on-admission (POA) coding and screening results for hospital scores across different medical conditions. It examines the distribution of total scores, risk-adjusted clinical performance, mortality rates, adverse outcomes, hospital costs, and readmission rates for conditions such as Congestive Heart Failure. The analysis includes insights on clinical effectiveness, practice performance across risk groups, and comparative cost-effectiveness assessments.

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Evaluation of the quality of Present-on-admission coding

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  1. Evaluation of the quality of Present-on-admission coding

  2. POA Screening Results for Sample Hospital Scores for High-Risk Medical Conditions * 1 = Best Result

  3. POA Screening Results for Sample Hospital Scores for Elective Surgical Procedures * 1 = Best Result

  4. POA Screening Results for Sample Hospital Scores for Labor and Delivery * 1 = Best Result

  5. POA Screening Results for Sample HospitalScores for General Screens and Aggregate Performance * 1 = Best Result

  6. Distribution of Hospital Total Scores

  7. Comparison of risk-adjusted clinical performance

  8. Observed and Predicted Hospital Mortality RatesCongestive Heart Failure

  9. Observed and Predicted Hospital Adverse Outcome RatesCongestive Heart Failure

  10. Hospital CostCongestive Heart Failure

  11. Adverse Outcomes and Hospital CostsCongestive Heart Failure 7.99% $5,596 13.82% $6,629

  12. Observed and Predicted 30-Day Readmission RateCongestive Heart Failure

  13. distribution of adverse outcomes

  14. Distribution of Adverse OutcomesCongestive Heart Failure Chi-square = 1.85 N.S.

  15. Asymmetrical Relationships of Observed and Predicted Outcomes Provide Insights about Clinical Effectiveness Effect of Risk on Performance Overall Results Less Success with Low Risk Balanced Less Success with High Risk Superior Superior Practice with Low Risk Cases Superior Practice Across All Risk Groups Superior Practice with High Risk Cases Average Potential Problems with High Risk Cases No Particular Strengths or Weaknesses Potential Problems with Low Risk Cases Suboptimal Special Problems with High Risk Cases Suboptimal Practice Across All Risk Groups Special Problems with Low Risk Cases

  16. Dynamic perspective using control charts

  17. Mortality RateCongestive Heart Failure

  18. Adverse Outcome RateCongestive Heart Failure

  19. Routine CostCongestive Heart Failure

  20. Comparative Effectiveness Outcome (Best Providers) Outcome (Worst Providers) assessment of comparative cost-effectiveness Risk Stratification Comparison Input (B† only in high risk) Input (Not A or C) Cost-Effective Conclusion (Best Practice = A with B† only in high risk) Ineffective

  21. Traditional Comparative Effectiveness AnalysesCongestive Heart Failure (First Line Therapy) Comparative Effectiveness Input A (+ Diuretics) Input A† (++ Diuretics) Comparative Effectiveness Input B† (+ Vasodilators) Input B (No Vasodilators) Comparative Effectiveness Input C (No Pressors) Input C† (+ Pressors) Conclusion (Best Practice = A+B† +C) Superior Inferior

  22. Patient-Centered Comparative Cost-Effectiveness AnalysisCongestive Heart Failure (First Line Therapy) Comparative Effectiveness Outcome (Best Providers) Outcome (Worst Providers) Risk Stratification Comparison Input (B† only in high risk) Input (Not A† or C†) Conclusion (Best Practice = A with B† only in high risk) Cost-Effective Ineffective

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