Utilization of Medical Codes for Hypotension in Shock Patients: A Retrospective Analysis.
| Autor: | Hunley C; Department of Critical Care Medicine, Orlando Regional Medical Center, Orlando, FL, USA., Murphy SME; Edwards Lifesciences, Irvine, CA, USA., Bershad M; Edwards Lifesciences, Irvine, CA, USA., Yapici HO; Boston Strategic Partners, Inc., Boston, MA, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of multidisciplinary healthcare [J Multidiscip Healthc] 2021 Apr 19; Vol. 14, pp. 861-867. Date of Electronic Publication: 2021 Apr 19 (Print Publication: 2021). |
| DOI: | 10.2147/JMDH.S305985 |
| Abstrakt: | Purpose: To evaluate the utilization of hypotension diagnosis codes by shock type and year in known hypotensive patients. Patients and Methods: Retrospective analysis of the Medicare fee-for-service claims database. Patients with a shock diagnosis code between 2011 and 2017 were identified using the International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification (ICD-9-CM and ICD-10-CM). Based on specific ICD codes corresponding to each shock type, patients were classified into four mutually exclusive cohorts: cardiogenic shock, hypovolemic shock, septic shock, and other/unspecified shock. Annual proportion and counts of cases with at least one hypotension ICD code for each shock cohort were generated to produce 7-year medical code utilization trends. A Cochran-Armitage test for trend was performed to evaluate the statistical significance. Results: A total of 2,200,275 shock patients were analyzed, 13.3% (n=292,192) of which received a hypotension code. Hypovolemic shock cases were the most likely to receive a hypotension code (18.02%, n=46,544), while septic shock cases had the lowest rate (11.48%, n=158,348). The proportion of patients with hypotension codes for other cohorts were 18.0% (n=46,544) for hypovolemic shock and 16.9% (n=32,024) for other/unspecified shock. The presence of hypotension codes decreased by 0.9% between 2011 and 2014, but significantly increased from 10.6% in 2014 to 17.9% in 2017 (p <0.0001, Z=-105.05). Conclusion: Hypotension codes are remarkably underutilized in known hypotensive patients. Patients, providers, and researchers are likely to benefit from improved hypotension coding practices. Competing Interests: Dr. Hunley received consulting fees from Edwards Lifesciences. Dr. Bershad and Ms. Murphy are employees of Edwards Lifesciences. Dr. Yapici is an employee of Boston Strategic Partners, Inc., which received funds from Edwards Lifesciences for research and editorial support. The authors report no other conflicts of interest in this work. (© 2021 Hunley et al.) |
| Databáze: | MEDLINE |
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