| Autor: |
Fu-Wen Liang, Liang-Yi Wang, Lin-Yi Liu, Chung Yi Li, Tsung-Hsueh Lu |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
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| Zdroj: |
BMC Health Services Research, Vol 20, Iss 1, Pp 1-7 (2020) |
| Druh dokumentu: |
article |
| ISSN: |
1472-6963 |
| DOI: |
10.1186/s12913-020-5001-5 |
| Popis: |
Abstract Background Most studies on the physician code creep (i.e., changes in case mix record-keeping practices to improve reimbursement) have focused on episodes (inpatient hospitalizations or outpatient procedures). Little is known regarding changes in diagnostic coding practices for better reimbursement among a fixed cohort of patients with chronic diseases. Methods To examine whether physicians in tertiary medical centers changed their coding practices after the initiation of the Outpatient Volume Control Program (OVCP) in Taiwan, we conducted a retrospective observational study of four patient cohorts (two interventions and two controls) from January 2016 to September 2017 in Taiwan. The main outcomes were the number of outpatient visits with four coding practices: 1) OVCP monitoring code recorded as primary diagnosis; 2) OVCP monitoring code recorded as secondary diagnosis; 3) non-OVCP monitoring code recorded as primary diagnosis; 4) non-OVCP monitoring code recorded as secondary diagnosis. Results The percentage change of the number of visits with coding practice 1 between 2016Q1 and 2017Q3 was − 74% for patients with hypertension and − 73% with diabetes in tertiary medical centers and − 23% and − 17% in clinics, respectively. By contrast, the percentage changes of coding practice 3 were + 73% for patients with hypertension and + 46% for patients with diabetes in tertiary medical centers and − 19% and − 2% in clinics, respectively. Conclusions Physician code creep occurred after the initiation of the OVCP. Education regarding appropriate outpatient coding for physicians will be relatively effective when proper coding is related to reimbursement. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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