Session Information
Date: Sunday, November 8, 2015
Title: Health Services Research Poster I: Diagnosis, Management and Treatment Strategies
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Systemic lupus erythematosus (SLE) is assumed to be associated with one of the highest hospital readmission rates among chronic illnesses. Based on a recently published (Arth Rheumatol (2014) 66:2828) electronic database analysis of Medicare/Medicaid hospital discharges, 16.5% of patients with the ICD-9-CM code 710.0 for SLE were readmitted to any hospital within 30 days. Our long–term research goals are to determine the 30-day all-cause readmission rate for adults with SLE in our tertiary care hospital, and to identify the risk factors for readmission. The aim of the current report was to determine the validity of SLE diagnosis among our hospitalized patients with an ICD-9-CM code of 710.0.
Methods: Potential admissions were identified through the electronic medical record system (EMR). From October 1, 2012 to December 30, 2014, index admissions were defined as hospital admissions from adult patients (≥ 18 years of age) who had a primary or secondary ICD-9-CM diagnosis of 710.0. Individual charts were then manually reviewed by a single rheumatology fellow to determine if the patient fulfilled the 1997 ACR revised criteria for SLE. Chart review included analysis of all documents dated as far back as the implementation of the EMR in 1997, including clinical visits, imaging studies and laboratory results.
Results: 1003 index admissions met our inclusion criteria, obtained from 433 unique patients. Only 196 (45%) of 433 patients fulfilled criteria for SLE. 237 (55%) patients did not meet criteria: 185 (43%) patients had an inappropriate diagnosis of SLE (i.e., chart review contained sufficient data to support an alternate diagnosis), 34 (8%) patients had limited cutaneous lupus, and 18 (4%) patients had insufficient data to either confirm or refute a diagnosis of SLE.
Conclusion: Our initial result demonstrates a 55% rate of miscoding of hospital records for adult patients with a primary or secondary diagnosis of SLE designated by the ICD-9-CM code 710.0. Our result brings into question the use of ICD-9-CM coding to evaluate readmission data in SLE.
To cite this abstract in AMA style:
Ali S, Mullis S, Al-Khoudari A, Ang D. Validity of the Inpatient Diagnosis of Systemic Lupus Erythematosus: Clarifying Hospital Readmission Rates [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/validity-of-the-inpatient-diagnosis-of-systemic-lupus-erythematosus-clarifying-hospital-readmission-rates/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/validity-of-the-inpatient-diagnosis-of-systemic-lupus-erythematosus-clarifying-hospital-readmission-rates/