Claims Data Lack Accuracy, Consistency Needed for Hospital Comparisons, Payments

Claims data, which are used to determine payments for performance and to publicly compare healthcare quality, may not be accurate sources to compare healthcare organizations or guide payment methods, according to a study published in the Annals of Internal Medicine.

 

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For the study, researchers examined claims data from 96 Michigan hospitals to compare urinary tract infections that are coded as hospital-acquired and catheter-associated events. The researchers also determined how often hospital payments were affected by catheter-associated urinary tract infections.

The researchers found only 2.6 percent of all hospital-acquired infections were described in the claims data as catheter-related, making financial savings based on nonpayment negligible. Further, epidemiologic studies report that most (59-86 percent) hospital-acquired urinary tract infections are catheter-associated, calling into question the accuracy of the claims data.

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