National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 1 of 1 Research Studies DisplayedDragan KL, Desai SM, Billings J
Association of insurance mix and diagnostic coding practices in New York state hospitals.
This study’s goal was to estimate whether, for the same Medicaid enrollee with multiple hospitalizations, a hospital's share of privately insured patients is associated with the number of diagnoses on claims since privately insured hospitals may invest more in intensive coding than hospitals serving publicly insured patients. This cross-sectional study used patient-level fixed effects regression models on inpatient Medicaid claims from Medicaid enrollees with at least 2 admissions in at least 2 different hospitals in the state of New York between 2010 and 2017. This analysis included 1,614,630 hospitalizations for Medicaid-insured patients (mean age, 48.2 years; 51.4% women and 48.6% men). Overall, 74,998 were Asian, 462,259 Black, 375,591 Hispanic, 486,313 White, 128,896 unknown, and 86,573 other. When the same patient was seen in a hospital with a higher share of privately insured patients, more diagnoses were recorded. Patients discharged from hospitals in the bottom quartile of privately insured patient share received 1.37 more diagnoses when they were subsequently discharged from hospitals in the top quartile, relative to patients whose admissions were both in the bottom quartile. This suggests that payment policy may drive differential investments in infrastructure to document diagnosis, causing a feedback loop that exacerbates resource inequity.
AHRQ-funded; T32HS000055; K01HS026980.
Citation: Dragan KL, Desai SM, Billings J .
Association of insurance mix and diagnostic coding practices in New York state hospitals.
JAMA Health Forum 2022 Sep 2;3(9):e222919. doi: 10.1001/jamahealthforum.2022.2919..
Keywords: Health Insurance, Hospitals