{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T13:53:20Z","timestamp":1740146000492,"version":"3.37.3"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,9,22]],"date-time":"2018-09-22T00:00:00Z","timestamp":1537574400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006513","name":"Duke Clinical Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006513","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002491","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002491","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Comorbid condition and hospital risk\u2010adjusted outcomes prevalence were compared based on clinical registry vs administrative claims data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Risk\u2010adjusted outcomes will vary depending on the source of comorbidity data used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical data from hospitalized Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology\/American Heart Association (ACC\/AHA) Guidelines (CRUSADE) non\u2010ST\u2010segment elevation myocardial infarction (NSTEMI) patients \u226565 years was linked to Medicare claims. Eight common comorbid conditions were coded and compared between registry data (derived from medical record review) and claims data; hospital\u2010level observed vs expected ratios and outlier status for 30\u2010day readmission and mortality were calculated using logistic generalized estimating equations for clinical vs claims data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 68 199 NSTEMI patients, 48.1% were female, 86.9% were white, and median age was 78. Degree of agreement between data sources for comorbid condition prevalence was 67.8% for myocardial infarction and 89.3% for diabetes. Overall, multivariable model performance was similar: Medicare mortality c\u2010statistics is 0.69 vs CRUSADE is 0.71; readmission c\u2010statistics is 0.59 for both. Hospital ratings were similar regardless of data source (mortality, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> = 0.97863; readmission, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> = 0.97858). Eighty\u2010two hospitals were mortality outliers in claims\u2010based models; of these, 70 were outliers in registry\u2010based models. Forty\u2010five hospitals were readmission outliers in claims\u2010based models; of these, 39 were outliers in registry\u2010based models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There were significant differences in individual comorbid condition prevalence when derived from registries vs claims, but hospital\u2010level outcomes were comparable.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23059","type":"journal-article","created":{"date-parts":[[2018,8,24]],"date-time":"2018-08-24T03:53:50Z","timestamp":1535082830000},"page":"1225-1231","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of clinical vs administrative claims coding on hospital risk\u2010adjusted outcomes"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8257-7561","authenticated-orcid":false,"given":"Emily C.","family":"O'Brien","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuang","family":"Li","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laine","family":"Thomas","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4049-3458","authenticated-orcid":false,"given":"Matthew T.","family":"Roe","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa051249"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb1002320"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1515"},{"key":"e_1_2_8_5_1","unstructured":"Centers for Medicare & Medicaid Services.Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and FY 2012 Rates and to the Long Term Care Hospital PPS and FY 2012 Rates. 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