scholarly journals Use of Medicare Diagnosis and Procedure Codes to Improve Detection of Surgical Site Infections following Hip Arthroplasty, Knee Arthroplasty, and Vascular Surgery

2012 ◽  
Vol 33 (1) ◽  
pp. 40-49 ◽  
Author(s):  
Michael S. Calderwood ◽  
Allen Ma ◽  
Yosef M. Khan ◽  
Margaret A. Olsen ◽  
Dale W. Bratzler ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Site Infections ◽  
Fold Increase ◽  
International Classification Of Diseases ◽  
Medicare Claims ◽  
Classification Of Diseases ◽  
Control And Prevention ◽  
Procedure Codes

Objective.To evaluate the use of routinely collected electronic health data in Medicare claims to identify surgical site infections (SSIs) following hip arthroplasty, knee arthroplasty, and vascular surgery.Design.Retrospective cohort study.Setting.Four academic hospitals that perform prospective SSI surveillance.Methods.We developed lists of International Classification of Diseases, Ninth Revision, and Current Procedural Terminology diagnosis and procedure codes to identify potential SSIs. We then screened for these codes in Medicare claims submitted by each hospital on patients older than 65 years of age who had undergone 1 of the study procedures during 2007. Each site reviewed medical records of patients identified by either claims codes or traditional infection control surveillance to confirm SSI using Centers for Disease Control and Prevention/ National Healthcare Safety Network criteria. We assessed the performance of both methods against all chart-confirmed SSIs identified by either method.Results.Claims-based surveillance detected 1.8–4.7-fold more SSIs than traditional surveillance, including detection of all previously identified cases. For hip and vascular surgery, there was a 5-fold and 1.6-fold increase in detection of deep and organ/space infections, respectively, with no increased detection of deep and organ/space infections following knee surgery. Use of claims to trigger chart review led to confirmation of SSI in 1 out of 3 charts for hip arthroplasty, 1 out of 5 charts for knee arthroplasty, and 1 out of 2 charts for vascular surgery.Conclusion.Claims-based SSI surveillance markedly increased the number of SSIs detected following hip arthroplasty, knee arthroplasty, and vascular surgery. It deserves consideration as a more effective approach to target chart reviews for identifying SSIs.Infect Control Hosp Epidemiol 2012;33(1):40-49

Surgical Site Infections, International Nosocomial Infection Control Consortium (INICC) Report, Data Summary of 30 Countries, 2005–2010

2013 ◽  
Vol 34 (6) ◽  
pp. 597-604 ◽  
Author(s):  
Victor D. Rosenthal ◽  
Rosana Richtmann ◽  
Sanjeev Singh ◽  
Anucha Apisarnthanarak ◽  
Andrzej Kübler ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Hip Prosthesis ◽  
Coronary Bypass ◽  
Surgical Site Infections ◽  
Abdominal Hysterectomy ◽  
International Classification Of Diseases ◽  
Surveillance Study ◽  
Classification Of Diseases ◽  
Control And Prevention

Objective.To report the results of a surveillance study on surgical site infections (SSIs) conducted by the International Nosocomial Infection Control Consortium (INICC).Design.Cohort prospective multinational multicenter surveillance study.Setting.Eighty-two hospitals of 66 cities in 30 countries (Argentina, Brazil, Colombia, Cuba, Dominican Republic, Egypt, Greece, India, Kosovo, Lebanon, Lithuania, Macedonia, Malaysia, Mexico, Morocco, Pakistan, Panama, Peru, Philippines, Poland, Salvador, Saudi Arabia, Serbia, Singapore, Slovakia, Sudan, Thailand, Turkey, Uruguay, and Vietnam) from 4 continents (America, Asia, Africa, and Europe).Patients.Patients undergoing surgical procedures (SPs) from January 2005 to December 2010.Methods.Data were gathered and recorded from patients hospitalized in INICC member hospitals by using the methods and definitions of the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) for SSI. SPs were classified into 31 types according toInternational Classification of Diseases, Ninth Revision, criteria.Results.We gathered data from 7,523 SSIs associated with 260,973 SPs. SSI rates were significantly higher for most SPs in INICC hospitals compared with CDC-NHSN data, including the rates of SSI after hip prosthesis (2.6% vs 1.3%; relative risk [RR], 2.06 [95% confidence interval (CI), 1.8–2.4];P<.001), coronary bypass with chest and donor incision (4.5% vs 2.9%; RR, 1.52 [95% CI, 1.4–1.6];P<.001); abdominal hysterectomy (2.7% vs 1.6%; RR, 1.66 [95% CI, 1.4–2.0];P<.001); exploratory abdominal surgery (4.1 % vs 2.0%; RR, 2.05 [95% CI, 1.6–2.6];P<.001); ventricular shunt, 12.9% vs 5.6% (RR, 2.3 [95% CI, 1.9–2.6];P<.001), and others.Conclusions.SSI rates were higher for most SPs in INICC hospitals compared with CDC-NHSN data.

Review of Current Literature on the Economic Burden of Clostridium difficile Infection

2009 ◽  
Vol 30 (1) ◽  
pp. 57-66 ◽  
Author(s):  
Erik R. Dubberke ◽  
Albert I. Wertheimer
Keyword(s):  
Clostridium Difficile ◽  
Economic Burden ◽  
International Classification Of Diseases ◽  
The United States ◽  
Diagnosis Code ◽  
Number Of Patients ◽  
Classification Of Diseases ◽  
Control And Prevention ◽  
Healthcare Associated

Clostridium difficile is well recognized as the most common infectious cause of healthcare-associated diarrhea. Since 2000, this pathogen has demonstrated an increased propensity to cause more frequent and virulent illness that is often refractory to treatment. An analysis by the Centers for Disease Control and Prevention revealed that, in the United States, the number of patients discharged from hospitals who received the International Classification of Diseases, Ninth Revision discharge diagnosis code for C. difficile infection (CDI) more than doubled from 2000 to 2003. Unpublished data indicate that this trend has continued and that more than 250,000 US hospitalizations were associated with CDI in 2005. A previously uncommon hypervirulent strain of C. difficile is thought to contribute, in part, to the dramatic increase in the incidence and severity of the infection. Although the economic impact of the disease is believed to be profound and is expected to increase, data on the costs associated with CDI are scarce. To more completely assess its economic burden, we performed a review of available literature that reported costs associated with the infection.

scholarly journals Effect of A Randomized trial of Unruptured Brain Arteriovenous Malformation on Interventional Treatment Rates for Unruptured Arteriovenous Malformations

2019 ◽  
Vol 47 (5-6) ◽  
pp. 299-302 ◽  
Author(s):  
Alexandra S. Reynolds ◽  
Monica L. Chen ◽  
Alexander E. Merkler ◽  
Abhinaba Chatterjee ◽  
Iván Díaz ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Arteriovenous Malformations ◽  
Population Level ◽  
International Classification Of Diseases ◽  
Interventional Treatment ◽  
Classification Of Diseases ◽  
Nationally Representative ◽  
Brain Avms ◽  
Join Point ◽  
Procedure Codes

Background: In 2013, investigators from A Randomized Trial of Unruptured Brain Arteriovenous Malformations (AVM; ARUBA) reported that interventions to obliterate unruptured AVMs caused more morbidity and mortality than medical management. Objective: We sought to determine whether interventions for unruptured AVM decreased after publication of ARUBA results. Methods: We used the Nationwide Readmissions Database to assess trends in interventional AVM management in patients ≥18 years of age from 2010 through 2015. Unruptured brain AVMs were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code 747.81 and excluding any patient with a diagnosis of intracranial hemorrhage. Our primary outcome was interventional AVM treatment, identified using ICD-9-CM procedure codes for surgical resection, endovascular therapy, and stereotactic radiosurgery. Join-point regression was used to assess trends in the incidence of interventional AVM management among adults from 2010 through 2015. Results: There was no significant U.S. population level change in unruptured brain AVM intervention rates before versus after ARUBA (p = 0.59), with the incidence of AVM intervention ranging from 8.0 to 9.2 per 10 million U.S. residents before the trial publication to 7.7–8.3 per 10 million afterwards. Conclusions: In a nationally representative sample, we found no change in rates of interventional unruptured AVM management after publication of the ARUBA trial results.

scholarly journals Clinical and Economic Burden of Antineutrophil Cytoplasmic Antibody–associated Vasculitis in the United States

2015 ◽  
Vol 42 (12) ◽  
pp. 2383-2391 ◽  
Author(s):  
Karina Raimundo ◽  
Amanda M. Farr ◽  
Gilwan Kim ◽  
George Duna
Keyword(s):  
Economic Burden ◽  
Healthcare Costs ◽  
Fold Increase ◽  
Antineutrophil Cytoplasmic Antibody ◽  
International Classification Of Diseases ◽  
The United States ◽  
Administrative Databases ◽  
Classification Of Diseases ◽  
Associated Conditions

Objective.To describe the prevalence of major relapse and healthcare costs among patients with granulomatosis with polyangiitis (GPA); to find patients with microscopic polyangiitis (MPA) in administrative databases, because no MPA diagnosis code exists; and to describe the clinical and economic burden associated with MPA.Methods.Adults (≥ 18 yrs) with ≥ 2 diagnoses of GPA [International Classification of Diseases-9-Clinical Modification (ICD-9-CM 446.4)] during 2009–2013 were extracted from the Truven Health MarketScan Commercial and Medicare Supplemental databases. Evidence of major relapse (based on the Birmingham Vasculitis Activity Score) and healthcare costs were collected during 12-month and 24-month followup periods. Adults with ≥ 2 diagnoses of unspecified arteritis (ICD-9-CM 447.6) were found as potential patients with MPA and additional criteria based on clinical input were applied to refine the sample. Major relapse-associated conditions and healthcare costs in the 6 months pre- and post-diagnosis were measured. Costs were inflated to 2013 US$.Results.A total of 2784 patients with GPA were found and 18.7% experienced a major relapse in the 12-month followup period. The patients with a major relapse incurred higher average all-cause (12-month: $88,065 vs $30,682; p < 0.0001) and GPA-related costs (12-month: $61,636 vs $15,748; p < 0.0001) than patients without a relapse. Trends were consistent over the 24-month followup period. There were 612 incident patients with MPA. Following MPA diagnosis, healthcare costs nearly doubled ($30,166 vs $56,642; p < 0.0001).Conclusion.In a real-world setting, patients with GPA who experience major relapse have higher economic burden, compared to patients without a relapse. MPA diagnosis was associated with nearly a 2-fold increase in healthcare costs.

scholarly journals Delay in Diagnosis of Invasive Surgical Site Infections Following Knee Arthroplasty Versus Hip Arthroplasty

2014 ◽  
Vol 60 (7) ◽  
pp. 990-996 ◽  
Author(s):  
Sarah S. Lewis ◽  
Kristen V. Dicks ◽  
Luke F. Chen ◽  
Michael P. Bolognesi ◽  
Deverick J. Anderson ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Site Infections ◽  
Delay In Diagnosis

Prescription Pattern Variability of Biologic Therapies in Treating Psoriasis

2018 ◽  
Vol 3 (3) ◽  
pp. 84-87 ◽  
Author(s):  
Emily Galli ◽  
Guodong Liu ◽  
Doug Leslie ◽  
Joslyn Kirby ◽  
Jeffrey J. Miller
Keyword(s):  
Geographic Location ◽  
Fold Increase ◽  
International Classification Of Diseases ◽  
Prescribing Patterns ◽  
Prescription Pattern ◽  
Pharmacy Claims ◽  
Included Patient ◽  
Classification Of Diseases ◽  
Us Census ◽  
Pattern Variability

Background: Medical conditions with high variability in clinical costs and outcomes, such as psoriasis, represent a critical area for health-care value improvement. Thus, the prescription pattern variability of psoriasis biologics merits further study. Objective: The purpose of our study was to determine whether there is variation in psoriasis biologic prescribing patterns. Methods: This study analyzed data from the Truven MarketScan Commercial Claims and Encounters database. Patients with International Classification of Diseases, Ninth Revision psoriasis diagnoses from January 1, 2008, to December 31, 2013, and continuously enrolled for at least 12 months were included. Patient sex, geographic location by census region, and new pharmacy claims for etanercept, adalimumab, and ustekinumab were included. Descriptive and multivariable analyses using logistic regression were performed. Results: Twenty nine thousand seven hundred thirty patients with psoriasis had 36 366 new prescription claims. Statistically significant differences in biologic pharmacy claims existed across US census region and year of claim. The South census region had the most prescriptions (per million population) of each biologic and the greatest increase in new prescriptions for adalimumab and ustekinumab, while the Northeast had the fewest. Etanercept pharmacy claims steadily decreased across all regions over time, while ustekinumab experienced an 8-fold increase. Conclusion: Prescription pattern variability for psoriasis biologics is associated with US census region and year of pharmacy claim.

Changes in the accuracy of administrative data for the detection of surgical site infections

2020 ◽  
pp. 1-3
Author(s):  
Brian T. Bucher ◽  
Meng Yang ◽  
Julie Arndorfer ◽  
Cherie Frame ◽  
Jan Orton ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Retrospective Analysis ◽  
Surgical Site Infections ◽  
International Classification Of Diseases ◽  
Site Infection ◽  
Diagnosis Codes ◽  
Infection Surveillance ◽  
Classification Of Diseases ◽  
Ninth Edition

Abstract We performed a retrospective analysis of the changes in accuracy of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes for colectomy and hysterectomy surgical site infection surveillance. After the transition from ICD-CM ninth edition to tenth edition codes, there was no significant change in the accuracy of these codes for SSI surveillance.

scholarly journals Improving the quality of care pathways for sarcoma patients and the advantages of using WCISU’s (Welsh Cancer Intelligence Surveillance Unit) national cancer registry

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Rowena Griffiths ◽  
Ashley Akbari ◽  
Dyfed Huws ◽  
Ronan Lyons ◽  
Martin Rolles ◽  
...  
Keyword(s):  
Cancer Registry ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Diagnosis And Treatment ◽  
Care Pathways ◽  
Hospital Data ◽  
National Cancer Registry ◽  
Classification Of Diseases ◽  
Procedure Codes

IntroductionSoft Tissue Sarcoma (STS) diagnosis is difficult due to its nature and the variability of its occurrence on the body. To improve patient outcomes a better understanding was needed of the care pathways experienced by the patient from initial presentation to final treatment. Objectives and ApproachSeveral items of information are necessary, within the data, to identify a care pathway. A correct STS diagnosis, a presentation date or first investigation date, a diagnosis date and any subsequent treatment dates. Identifying cases in hospital data, using International Classification of Diseases (ICD10) codes - C40, C41, C47 and C49 - based on cancer site - can miss cases and cause difficulties when trying to distinguish the difference between the investigation and treatment stages. Having access to WCISU’s national cancer registry, proved advantageous and enabled the routine data to be validated. ResultsAttempts to identify differences between investigative and treatment procedures using the procedure codes available in hospital data was unhelpful due to variations in coding. However, WCISU’s national cancer registry records all cases of cancer diagnosed in Wales using both ICD10 and International Classification of Diseases for Oncology codes to record cancer morphology. In addition, it records the date of diagnosis and treatment start dates. Using the cancer registry it was possible to cross-check the cases extracted from the hospital data and identify the diagnosis and treatment dates. By matching the treatment dates back to the hospital data it then became possible to analyse the procedure codes to see how many treatments were being delivered, the type of treatment and the periods covered. Conclusion/ImplicationsOnce accurate diagnosis and treatments dates were identified, it was possible to drill further into the hospital data to see the finer detail of the procedures the patient received. Utilising independent data sources made it possible to develop an enriched view of patient care pathways from diagnosis through to treatment.

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